Modified radical lymphadenectomy without splenectomy in patients with proximal gastric cancer: comparison with standard D2 lymphadenectomy for distal gastric cancer.

Background And Objectives: We assessed the optimal extent of lymph node dissection and the effect of splenectomy in patients with proximal gastric cancer.

Method: Recurrence and survival rates were compared between 881 patients with proximal gastric cancer who underwent modified radical lymphadenectomy and 3,098 patients with distal gastric cancer who underwent standard D2 lymphadenectomy.

Results: The recurrence rate was significantly higher in the total than in the distal gastrectomy group (32.