Garg PK, Jakhetiya A, Sharma J, Ray MD, Pandey D. Lymphadenectomy in gastric cancer: Contentious issues. World J Gastrointest Surg 2016; 8(4): 294-300 [PMID: 27152135 DOI: 10.4240/wjgs.v8.i4.294]
Corresponding Author of This Article
Dr. Pankaj Kumar Garg, Associate Professor, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India. dr.pankajgarg@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Pankaj Kumar Garg, Ashish Jakhetiya, Jyoti Sharma, Mukur Dipi Ray, Durgatosh Pandey, Department of Surgical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India
Pankaj Kumar Garg, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
Author contributions: Garg PK conceptualized the study; Garg PK, Jakhetiya A and Sharma J searched the literature, analyzed the retrieved literature and wrote the initial draft; Ray MD and Pandey D provided critical inputs in literature search and analysis and drafting the manuscript; all the authors read the final draft and approved it.
Conflict-of-interest statement: There is no conflict of interest associated with any of the author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Pankaj Kumar Garg, Associate Professor, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India. dr.pankajgarg@gmail.com
Telephone: +91-1122-592536 Fax: +91-1122-590495
Received: September 29, 2015 Peer-review started: October 2, 2015 First decision: November 4, 2015 Revised: December 25, 2015 Accepted: February 14, 2016 Article in press: February 16, 2016 Published online: April 27, 2016 Processing time: 204 Days and 3.2 Hours
Abstract
The stomach is the sixth most common cause of cancer worldwide. Surgery is an important component of the multi-modality treatment of the gastric cancer. The extent of lymphadenectomy has been a controversial issue in the surgical management of gastric cancer. The East-Asian surgeons believe that quality-controlled extended lymphadenectomy resulting in better loco-regional control leads to survival benefit in the gastric cancer; contrary to that, many western surgeons believe that extended lymphadenectomy adds to only postoperative morbidity and mortality without significantly enhancing the overall survival. We present a comprehensive review of the lymphadenectomy in the gastric cancer based on the previously published randomized controlled trials.
Core tip: The only potentially curative option for the gastric cancer is surgery which may promise complete resection. Presently, D2 lymphadenectomy is the standard of care in an operable gastric cancer. Routine excision of spleen and pancreatic tail should not be undertaken as it increases the postoperative morbidity without adding significantly to overall survival.
