简介：Objective:Curativegastriccancersurgeryentailsremovaloftheprimarytumorwithadequatemarginsincludingregionallymphnodes.Europeanrandomizedcontrolledtrialswithrecruitmentinthe1990'sreportedincreasedmorbidityandmortalityforD2comparedtoD1.Here,weexaminedtheextentoflymphadenectomyduringgastriccancersurgeryandtheassociatedriskforpostoperativecomplicationsandmortalityusingthestrengthsofapopulation-basedstudy.Methods:AprospectivenationwidestudyconductedwithintheNationalRegisterofEsophagealandGastricCancer.AllpatientsinSwedenfrom2006to2013whounderwentgastriccancerresectionswithcurativeintentwereincluded.PatientswerecategorizedintoD0,D1,orD1+/D2,andanalyzedregardingpostoperativemorbidityandmortalityusingmultivariablelogisticregression.Results:Intotal,349(31.7%)patientshadaD0,494(44.9%)D1,and258(23.4%)D1+/D2lymphadenectomy.The30-dpostoperativecomplicationrateswere25.5%,25.1%and32.2%(D0,D1andD1+/D2,respectively),and90-dmortalityrateswere8.3%,4.3%and5.8%.Afteradjustmentforconfounders,inmultivariableanalysis,therewerenosignificantdifferencesinriskforpostoperativecomplicationsbetweenthelymphadenectomygroups.For90-dmortality,therewasalowerriskforD1vs.D0.Conclusions:ThemajorityofgastriccancerresectionsinSwedenhaveincludedonlyalimitedlymphadenectomy(D0andD1).Moreextensivelymphadenectomy(D1+/D2)seemedtohavenoimpactonpostoperativemorbidityormortality.