In the therapeutic strategy of gastric cancer extension of lymphectomy is still controversial. Results of extended lymphadenectomy as reported in the literature by Japanese groups do not find correspondence in the series reported by the Western groups; no study, up to date, has clearly demonstrated the superiority of an extended versus a limited lymphectomy. The former approach results in an increased number of postoperative complications and a higher mortality rate. The surgical oncologist has to face the difficult issue of treating lymph nodes “clinically” which are not affected by the disease. So once more the questions are: elective extended lymphadenectomy or not? Bearing in mind the increase in morbidity, is it advantageous for the surgeon to perform a lymphectomy in a N0 patient; or if regional nodes are negative, should the surgeon approach the lymph nodes anyway? Is it therapeutic to excise negative lymph nodes? If the answer to all these questions is no, then it seems appropriate to explore those procedures that could potentially predict intraoperatively the involvement of lymph nodes; this would lead to a guided lymphectomy where possible. Selective lymphadenectomy has been demonstrated applicable in almost 100% of breast cancer and melanoma thanks to improvements in the sentinel lymph-node techJournal of Chemotherapy Vol. 11 n. 3 (230-231) 1999