Therapeutic value of dissecting stations 1 and 4Sb lymph nodes during radical distal gastrectomy for lower- and middle-third gastric cancer

Routine dissection of station 4Sb LNs in LGC offers negligible survival benefit. Furthermore, given that station 1 metastasis is not an independent prognostic factor in LGC, its routine dissection also warrants reconsideration. These findings support a biology-driven refinement of lymphadenectomy guidelines, suggesting that omitting station 4Sb and selectively omitting station 1 in LGC may be oncologically safe. Prospective validation is crucial.