Extended lymphadenectomy improvement of overall survival of gastric cancer patients with perigastric node metastasis

The superiority of extended lymphadenectomy for the prognosis of gastric cancer (GC) is still controversial. The authors hypothesized that extended lymphadenectomy could improve the overall survival (OS) of GC patients with a specific extent of lymph node metastasis. Data from 456 GC patients who underwent curative gastrectomy with lymphadenectomy were used to illuminate the difference of OS between patients who underwent limited lymphadenectomy and patients who underwent extended lymphadenectomy. As a whole, there was no significant difference of OS between patients who underwent extended lymphadenectomy and patients who underwent limited lymphadenectomy in all 456 GC patients. However, we demonstrated that extended lymphadenectomy significantly improved the OS of GC patients with perigastric lymph node metastasis (n1 stage based on the Japanese Gastric Cancer Association classification) compared to limited lymphadenectomy (P = 0.023). Furthermore, the more the negative lymph nodes were, the longer the OS of GC patients with perigastric node metastasis following extended lymphadenectomy was (P < 0.001). Extensive lymph node dissection and good harvest of negative lymph nodes should be deemed as the most important factors to improve the OS of GC patients with perigastric node metastasis.