Extended lymph node dissection benefits older gastric cancer patients

Removing 35 or more lymph nodes was linked to better survival in every age group, including patients 75 and older.

• Patients with 35 or more nodes examined had a 26% lower risk of death than those with fewer than 16 (HR 0.74, patients 75 and older).
• The survival link held in patients 80 and older and in those given neoadjuvant chemotherapy.
• Greater nodal yield did not raise the odds of 30-day mortality, readmission, or prolonged stay in any age group.

Age alone should not be a reason to limit lymphadenectomy in resectable gastric adenocarcinoma. This was a retrospective national database study, so it shows association, not proof that more nodes cause better survival.