D2 Lymphadenectomy for Gastric Cancer: Advancements and Technical Considerations

Society of Surgical Oncology Gastrointestinal Disease Site Workgroup

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Lymphadenectomy (LND) is a crucial component of the curative surgical treatment of gastric cancer (GC). The LND serves to both accurately stage the disease and offer therapeutic benefits. At the time of “curative-intent” gastrectomy, D2 LND is the optimal treatment for patients with locally advanced GC due to its survival benefits and acceptable morbidity. Mastery of the technical aspects of LND, especially D2, requires significant training, adequate case volume, and expertise. This review discusses key aspects of D2 LND, including its status as the standard treatment for locally advanced GC, definition and anatomic borders, technical details, and controversial topics such as splenic hilar dissection and omentectomy. The application of indocyanine green (ICG) fluorescence imaging to elucidate the drainage patterns of GC and to facilitate lymph node (LN) identification is briefly reviewed. Finally, GC standardization and centralization, including surgical treatment, are discussed.

Original languageEnglish (US)
Article number101963
Pages (from-to)2129-2140
Number of pages12
JournalAnnals of Surgical Oncology
Volume32
Issue number3
DOIs
StatePublished - Mar 2025

Keywords

  • D2
  • Dissection
  • Gastric cancer
  • Lymph node
  • Lymphadenectomy
  • Technique

ASJC Scopus subject areas

  • Surgery
  • Oncology

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