Abstract: On the basis of randomized clinical trials, the extended (D2) lymph node dissection is now recommended as a globally stan -dard procedure for locally advanced gastric cancer. However, the rational extent of lymphadenectomy for locally advanced gastric can-cer has remained a topic of debate in the past decades. The examined lymph node and extra-nodal metastasis are significantly associ -ated with the survival of gastric cancer patients. Furthermore, the role of splenectomy for complete resection of No. 10nodes has been controversial; however, the randomized trial of JCOG 0110is yet to be completed. Gastric cancer with No. 14lymph node metas -tasis is defined as M 1 stage in the current version of the Japanese classification. We propose that D 2 +No. 14v lymphadenectomy may be an option in a potentially curative gastrectomy for tumors with apparent metastasis to the No.6 nodes or infiltrate to duodenum. In view of the limitation of low metastatic rate in para- aortic lymph nodes in Japan Clinical Oncology Group (JCOG 9501), the clinical benefits of D2 +PAND for patients with stage T 3 and/or stage N3 disease, both of which are very common in China and many other coun -tries except Japan and Korea, cannot be determined.