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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)