Meta-analysis of effectiveness and safety of D2 plus para-aortic lymphadenectomy for resectable gastric cancer.

Study selection Randomised controlled trials (RCTs) that compared D2 plus para-aortic lymphadenectomy (including dissection of middle para-aortic lymph nodes, 16a2, 16b1) with standard D2 lymphadenectomy in patients with resectable, biopsydiagnosed, gastric adenocarcinoma were eligible for inclusion in the review. Studies had to report more than one of the specified outcome measures. The primary outcome of interest was five-year overall survival. Secondary outcomes were in-hospital or postoperative 30-day mortality and postoperative morbidity (including anastomotic leakage, pancreatic fistula, abdominal abscess, postoperative bleeding, obstruction or ileus, wound infection and cardiocirculatory and pulmonary complications associated with the procedure).