Can sentinel node biopsy indicate rational extent of lymphadenectomy in gastric cancer surgery? Fundamental and new information on lymph node dissection

Lymph-node dissection has been regarded as an effective surgical treatment for gastric cancer in Japan. It reduces local recurrence and improves survi val rate. Japanese-style systematic D2 lymphadenectomy is now being introdu ced in western countries for treatment of gastric cancer. This surgical pro cedure, however, is not simple and should be performed by experienced surge ons. And it is too early to apply sentinel node biopsy for reducing extent of lymphadenectomy because of so complicated lymphatic streams from the sto mach and frequent skip- and micrometastases.