{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:30:13Z","timestamp":1786645813829,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The appropriate extent of lymph node dissection (LND) during palliative gastrectomy (PALG) for stage IV gastric cancer remains undefined. This study evaluated short\u2010term surgical outcomes of limited versus extended LND in PALG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed 855 patients undergoing PALG with pathologically confirmed stage IV gastric cancer from the pooled Korean Gastric Cancer Association nationwide survey registries of 2019 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a014,076 and 68 hospitals) and 2023 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a012,752 and 72 hospitals). Patients were stratified by the number of retrieved lymph nodes into limited LND (&lt; 15 nodes and\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a062) and extended LND (\u2265 15 nodes and\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0793). Confounding by indication was addressed using overlap (ATO)\u2010based propensity score weighting (PSW) with double\u2010robust multivariable regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Before weighting, the limited LND group had higher 30\u2010day complication (43.5% vs. 29.8% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.023) and mortality rates (17.7% vs. 6.8% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005). After ATO\u2010based PSW (SMD &lt; 0.001 for all covariates), extended LND showed lower odds of 30\u2010day complications (weighted OR 0.54 [95% CI 0.31\u20130.95]; double\u2010robust OR 0.50 [0.28\u20130.87]); and mortality (double\u2010robust OR 0.26 [0.10\u20130.64]). Pneumonia drove the dominant difference (14.8% vs. 3.7% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Hospital stay remained longer in the limited LND group after weighting (19.9\u00a0\u00b1\u00a018.3 vs. 12.8\u00a0\u00b1\u00a012.8\u00a0days and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After rigorous adjustment for confounding by indication, extended LND in PALG was not associated with excess short\u2010term morbidity or mortality. The lower event rates in the extended LND group most likely reflect preferential selection of frailer, more advanced patients for limited LND rather than a causal benefit. In appropriately selected patients at experienced centers, limiting dissection should not be assumed inherently safer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70521","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:40:17Z","timestamp":1786642817000},"source":"Crossref","is-referenced-by-count":0,"title":["Short\u2010Term Surgical Outcomes of Palliative Gastrectomy According to the Extent of Lymph Node Dissection: A Nationwide Propensity Score\u2013Weighted Cohort Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9061-6236","authenticated-orcid":false,"given":"Sang\u2010Ho","family":"Jeong","sequence":"first","affiliation":[{"name":"Department of Surgery Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital  Changwon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5868-0465","authenticated-orcid":false,"given":"Rock Bum","family":"Kim","sequence":"additional","affiliation":[{"name":"Regional Cardiocerebrovascular Disease Center Gyeongsang National University Hospital  Jinju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyeong","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital  Changwon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Won","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Surgery Kosin University Gospel Hospital  Busan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5798-4595","authenticated-orcid":false,"given":"Jae\u2010Seok","family":"Min","sequence":"additional","affiliation":[{"name":"Division of Foregut Surgery, Department of Surgery Korea University College of Medicine Korea University Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Information Committee of the Korean Gastric Cancer Association","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1468488"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12010158"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120\u2010022\u201001331\u20108"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo.2020.01.07"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010024\u201012860\u2010z"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(15)00553\u20107"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.14309\/ctg.0000000000000048"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120\u2010025\u201001676\u2010w"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.17430"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.5230\/jgc.2021.21.e27"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.5230\/jgc.2025.25.e8"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010025\u201014149\u20101"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12883"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2013.031"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/0102\u2010672020230072e1790"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57030198"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12402"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010017\u20100192\u20101"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.723065"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70521","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70521","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:40:18Z","timestamp":1786642818000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":20,"alternative-id":["10.1002\/wjs.70521"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70521","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"wjs.70521"}}