Interventions
Gastric Cancer, JGCA
GASTRIC CANCER, GASTRIC CANCER
The study design is shown in Fig. Study designPatients underwent laparoscopic distal gastrectomy with D2 lymphadenectomy according to international guidelines. Surgery was performed by two senior surgeons (CS or VM) with extensive experience (>30 interventions each) in laparoscopic surgery for gastric cancer.Standard D2 lymphadenectomy was performed according to Japanese Gastric Cancer Association (JGCA) guidelines,The surgical specimen was prepared by the surgical team together with the pathologist. Each nodal station was individually separated according to JGCA definitions, as shown in Supplementary Fig. 1, and evaluated for the presence or absence of lymph nodes.After surgery, follow-up was performed with physical examination, blood tests, and cross-sectional imaging with computed tomography every 3–4 months for the first 2 years and every 6 months for the subsequent 3 years, with variations in the timing of the first follow-up depending on receipt of adjuvant chemotherapy versus observation. Timing of endoscopic surveillance was decided on a case-by-case basis depending on stage.