A new study shows that the extent of lymph node dissection impacts immunotherapy efficacy in recurrent gastric cancer, emphasizing precise surgical strategies.

• Patients with moderate lymph node dissection (16-30 nodes) achieved the best progression-free survival (8.0 months) compared to insufficient (≤15 nodes, 6.0 months) and excessive (>30 nodes, 7.0 months) resections.
• Overall survival was highest in the moderate dissection group, with a median of 18.0 months versus 14.0 months for insufficient and 13.0 months for excessive dissections.

Surgeons should aim for balanced lymphadenectomy to enhance patient outcomes while maintaining antitumor immunity.

• Multivariate analysis identified lymph node count as the sole independent predictor of survival outcomes.