Published online Jun 15, 2016. doi: 10.4251/wjgo.v8.i6.489
Peer-review started: January 18, 2016
First decision: February 22, 2016
Revised: March 24, 2016
Accepted: April 14, 2016
Article in press: April 18, 2016
Published online: June 15, 2016
The amount of lymph node dissection (LD) required during surgical treatment of gastric cancer surgery has been quite controversial. In the 1970s and 1980s, Japanese surgeons developed a doctrine of aggressive preventive gastric cancer surgery that was based on extended (D2) LD volumes. The West has relatively lower incidence rates of gastric cancer, and in Europe and the United States the most common LD volume was D0-1. This eventually caused a scientific conflict between the Eastern and Western schools of surgical thought: Japanese surgeons determinedly used D2 LD in surgical practice, whereas European surgeons insisted on repetitive clinical trials in the European patient population. Today, however, one can observe the results of this complex evolution of views. The D2 LD is regarded as an unambiguous standard of gastric cancer surgical treatment in specialized European centers. Such a consensus of the Eastern and Western surgical schools became possible due to the longstanding scientific and practical search for methods that would help improve the results of gastric cancer surgeries using evidence-based medicine. Today, we can claim that D2 LD could improve the prognosis in European populations of patients with gastric cancer, but only when the surgical quality of LD execution is adequate.
Core tip: The amount of lymph node dissection required during surgical treatment of gastric cancer has been quite controversial. We can now claim that D2 lymph node dissection improves the prognosis in European populations with gastric cancer, but only when the surgical quality of the lymph node dissection execution is adequate.