Lymphadenectomy in gastric cancer treatment requires tailored approaches for different patient scenarios.

• Individualized decisions for lymphadenectomy are crucial based on patient factors and radiographic nodal involvement, especially in conversion and cytoreductive surgeries.
• Optimal lymphadenectomy extent for gastroesophageal junction cancers is driven by tumor classification and invasion length.

Surgeons need to consider unique drainage patterns in remnant gastric cancer for proper lymph node selection and staging accuracy.

• Lymphadenectomy is critical for MSI-high tumors despite their favorable prognosis and is not needed for most gastrointestinal stromal tumors unless specific conditions apply.