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John A. Butler, MD
Orange, Calif

Arch Surg. 2004;139:669.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The efficacy of extended lymphadenectomy in the surgical treatment of gastric cancer remains a source of considerable controversy in the surgical literature. The Japanese results that provide the most compelling data in support of extended, or D2, dissections have not been duplicated in trials performed in Western countries. Both stage migration and an evolving body of literature supporting less aggressive tumor biology for Asian gastric cancers partially explain the survival differences between East and West. While flaws in both the design and conduct of several of these clinical trials have been identified, the results of the Dutch and English randomized trials offer no justification for the routine use of D2 dissection, leaving open the possibility of a limited benefit for the subset of patients having stage II or IIIA disease.

Khatri and Douglass provide a methodical and well-illustrated description of the operative technique used in a . . . [Full Text of this Article]

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D2.5 Dissection for Gastric Carcinoma
Vijay P. Khatri and Harold O. Douglass, Jr
Arch Surg. 2004;139(6):662-669.
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