Li SS, et al. - In a large Western series of 520 patients with gastroesophageal carcinoma undergoing potentially curative resection, patients undergoing limited (D0/D1) were compared with those undergoing extended (D1+/D2) lymphadenectomy (LAD) regarding the perioperative risk and survival outcomes. A total of 362 (70%) patients underwent D0/D1 LAD and 158 (30%) underwent D1+/D2 LAD. Compared to patients undergoing D0/D1 LAD, patients undergoing D1+/D2 LAD more frequently have distal tumors, undergo distal/subtotal/total gastrectomy, and undergo operation at a more contemporary time. Outcomes suggest that at a high-volume Western center, gastrectomy with extended (D1+/D2) LAD can be performed safely. It leads to significant improvement in nodal yield and ensures accurate pathologic staging.