ArticleAmerican journal of translational research2025
Analysis of the efficacy and safety of extended lymph node dissection in gastric cancer surgery: association with dissection quantity, inflammatory response, and complications.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the comparative efficacy and safety of standard lymphadenectomy (D2) versus extended lymphadenectomy (D2+) in gastric cancer surgery. Additionally, we explored the relationship between the number of dissected lymph nodes, the magnitude of postoperative inflammatory response, and long-term survival outcomes.
methodsA retrospective cohort was conducted on clinical data from 421 patients diagnosed with gastric cancer and treated between April 2019 and January 2022. Among them, 189 underwent standard D2 dissection and 232 received extended D2+ lymph node dissection. All patients received neoadjuvant chemotherapy followed by radical gastrectomy. Baseline characteristics, intraoperative and postoperative outcomes, inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6), complication rates, and survival metrics (3-year overall survival (OS) and progression-free survival (PFS)) were compared between groups. Univariate and multivariate Cox proportional hazards models were applied to identify survival-associated factors. Kaplan-Meier survival curves were constructed for subgroup analysis by TNM (tumor-node-metastasis) stage.
resultsThere were no significant differences in baseline characteristics between the D2 and D2+ groups (P > 0.05). Compared to the D2 group, the D2+ group exhibited significantly longer operative times, greater intraoperative blood loss, and more lymph nodes dissected (all P < 0.001), while the length of hospital stay remained similar between the two groups (P = 0.708). Postoperative levels of CRP, TNF-α, and IL-6 were significantly elevated in the D2+ group (all P < 0.001), correlating positively with the number of lymph nodes removed (all P < 0.001). The incidence of postoperative complications did not differ between groups (P > 0.05). Notably, the D2+ group demonstrated a superior 2-year OS rate (P = 0.002) and significantly improved 3-year OS in patients with stage II disease (P = 0.018). However, no significant differences were observed in 1-year OS (P = 0.067), 3-year OS (P = 0.699), or 3-year OS for stage III patients (P = 0.428). Multivariate Cox regression analysis identified extended D2+ dissection, younger age, lower TNM stage, and higher tumor differentiation as independent protective factors for PFS (all P < 0.05).
conclusionExtended D2+ lymph node dissection improves survival outcomes, particularly in stage II gastric cancer patients, without increasing postoperative complication risk. However, it induces a more robust inflammatory response. These findings suggest that D2+ dissection should be selectively considered, weighing the oncological benefits against the potential inflammatory burden, particularly in stage II patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.