Value of extended lymph node dissection in the treatment of gastric cancer

Regional lymph node metastasis is a critical prognostic factor in gastric cancer, and extended lymph node dissection and routine microscopic examination of all resected nodes could potentially provide accurate information regarding lymph node status. On the other hand, the therapeutic value of extended lymph node dissection is controversial. While retrospective and prospective non-randomised comparative studies have shown that extended lymph node dissection significantly improves the survival rate, prospective randomised trials have failed to demonstrate the efficacy of extended dissection, although the number of patients in these studies was limited. The present review of the literature therefore considers the prognostic significance of regional lymph node metastases and the therapeutic efficacy of lymph node dissection performed for gastric cancer.