D2 lymphadenectomy for gastric cancer: Advancements and technical considerations Review


Authors: Dehal, A.; Woo, Y.; Glazer, E. S.; Davis, J. L.; Strong, V. E.; and Society of Surgical Oncology Gastrointestinal Disease Site Workgroup
Review Title: D2 lymphadenectomy for gastric cancer: Advancements and technical considerations
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.
Keywords: lymphadenectomy; dissection; lymph node; surgery; perioperative chemotherapy; technique; long-term survival; gastric cancer; randomized; clinical-trial; lymph-node dissection; staging system; preoperative chemotherapy; quality-control; d2; preserving total gastrectomy; 8th edition
Journal Title: Annals of Surgical Oncology
Volume: 32
Issue: 3
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2025-03-01
Start Page: 2129
End Page: 2140
Language: English
ACCESSION: WOS:001363445200001
DOI: 10.1245/s10434-024-16545-6
PROVIDER: wos
PUBMED: 39589578
Notes: Review -- Erratum issued, see DOI: 10.1245/s10434-025-17552-x -- Source: Wos
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  1. Vivian Strong
    265 Strong