Recent Evolution of Surgical Treatment for Gastric Cancer in Korea

Abstract

Gastric cancer is the most common malignancy and the incidence is steadily increasing in Korea. The principal treatment modality for gastric cancer is surgical extirpation of tumor along with draining lymph nodes. Gastrectomy with D2 lymph node dissection has been well established as a standard of surgery and improved the survival of gastric cancer patients. Recently, technological advances are drastically reshaping the landscape of surgical treatment of gastric cancer. One of the most notable trends is that minimal access surgery becomes dominating the treatment of early stage diseases. For advanced diseases, the standard access surgery is considered a reference treatment. Although there is a pilot study underway to evaluate the feasibility of the application of minimal access surgery to advanced gastric cancer (AGC), the evidence for oncological safety is not yet provided sufficiently. Based on the recent randomized controlled trials, the extent of surgery for AGC has re-defined as para-aortic lymph node dissection dose not add any survival benefit while increasing surgery-related morbidities. In addition, it is now accepted as a standard operation omitting unnecessary procedures such as splenectomy and/or distal pancreatectomy for prophylactic lymph node dissection. Conceptual and technical innovation has contributed to decreasing morbidity and mortality without impairing oncological safety. All these recent advances in the field of gastric cancer surgery would be concluded in maximizing therapeutic index for gastric cancer while improving quality of life.

First experiences with laparoscopic assisted distal gastrectomy: in the view of comparison with high volume centers

“…Operations were performed from 2009 to 2012 in our study and from 1998 to 2005 in the KLASS study. Many surgical devices including ultrasonic scissors, surgical stapler, laparoscopic camera and high-definition system are constantly evolving and this fact could have affected our data [2]. But another report that had a similar period to our study showed similar data to ours.…”

“…The multidisciplinary treatment of gastric cancer is evolving at a rapid rate and recently there has been an increase in the survival rate and a reduction of the morbidity and mortality rates after surgery [1,2]. Surgical techniques including minimal invasive surgery have been one of the fastest advancements in the treatment of gastric cancer [2].…”

Pathologic and Oncologic Outcomes in Locally Advanced Gastric Cancer with Neoadjuvant Chemotherapy or Chemoradiotherapy

“…Gastrectomy with D2 lymph node dissection and extended surgery for resection of involved organs is the current standard of care for advanced gastric cancer 5,7,8. In recent years, a multidisciplinary treatment approach, including perioperative CTx, radiotherapy, and targeted therapy, has emerged for advanced gastric cancer, resulting in increased curability and improved survival.…”

Relationships between gastrointestinal symptoms, uncertainty, and perceived recovery in patients with gastric cancer after gastrectomy

“…Although the incidence of gastric cancer has recently declined, it remains the second most common cause of cancer‐related death worldwide. Surgical removal of the stomach is the primary treatment for gastric cancer (An et al ., ; Bickenbach & Strong, ). Because the cure rate has improved as a result of early diagnosis and treatment of gastric cancer, the mortality of this disease has decreased, leading to an increased number of gastric cancer survivors (Park et al ., ; Ministry of Health and Welfare, ).…”