Standardized implementation and quality control of lymph node dissection in advanced gastric cancer

Lymph node metastasis is one of the major metastatic pathways in gastric cancer and is a key determinant of tumor staging, treatment decision‑making, and long‑term prognosis. Standardized D₂ lymphadenectomy not only facilitates the removal of potential metastatic disease but also provides the basis for accurate pathological staging and subsequent multidisciplinary treatment. With the development of precision surgery concepts for gastric cancer, lymph node dissection strategies have shifted from the extent of dissection to the quality of dissection. The authors discuss the standardized selection of lymphadenectomy extent, technical foundations of high‑quality D₂ lymphadenectomy, quality assessment systems, and lymphadenectomy strategies in the era of neoadjuvant therapy. It is believed that standard D₂ lymphadenectomy remains the cor-nerstone of surgical treatment for locally advanced gastric cancer. Future efforts should focus on standardized surgical procedures, objective quality assessment systems, and precision treatment strategies to achieve an optimal balance between oncological benefit and surgical safety.