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Table 1 The results of randomized clinical trials comparing the efficacy of D2 lymphadenectomy to D3 or D4 (D3+) lymphadenectomy

From: Recent trends from the results of clinical trials on gastric cancer surgery

Author Year Number of patients Country Tumor depth Comparative arma Survival results Morbidity D2 vs. D3 (%)
Maeta et al. [17] 1997 70 Japan T3–T4 D2+ vs. D4 (D3+) NS 26.0 vs. 40.0
Wu et al. [33] 2006 221 Japan, Korea, China, Taiwan T2–T4/N1–3 D2 vs. D4 (D3+) Unknown 7.3 vs. 17.1
Kulig et al. [18] 2007 550 Poland T1–T3 D2 vs. D3 NS 27.7 vs. 21.6
Sasako et al. [16] 2008 523 Japan T2–T4 D2 vs. D3 NS 20.9 vs. 28.1
Yonemura et al. [19] 2008 269 Japan, Korea, Taiwan T2–T4 D2 vs. D3 NS Mortality: 0.7 vs. 3.7
  1. T, depth of tumor infiltration; N, number of metastasized lymph nodes; D, types of lymphadenectomy; NS: not significant
  2. aThe different types of lymphadenectomies performed in the comparative arms of the respective randomized clinical trials: D2+: D2 lymphadenectomy plus dissection of lymph nodes located at the hepatoduodenal ligament, in the retro-pancreatic space and along the vessels of the transverse mesocolon. D3: D2 lymphadenectomy plus dissection of lymph nodes located at the para-aortic lymph node dissection from the upper margin of the celiac trunk to the lower margin of the left renal vein. D4 (D3+): D2 lymphadenectomy plus dissection of lymph nodes located at the para-aortic lymph nodes from the aortic hiatus to the aortic bifurcation (hepatoduodenal ligament, in the retro-pancreatic space and along the vessels of transverse mesocolon)