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The best reported long-term survival following surgery for gastric cancer is from centers performing radical D2 gastrectomy. Yet comparative studies from European centers report higher rates of postoperative complications following D2 gastrectomy than after the less radical D1 gastrectomy, without any benefit in survival. We aimed to compare the outcome after modified D2 gastrectomy (preserving spleen and pancreas where possible), performed by specialist surgeons, with that after conventional D1 gastrectomy performed by general surgeons for gastric cancer in a large United Kingdom cancer unit.

D2 or not D2? The gastrectomy question