The current state of stomach cancer surgery in the world

Abstract

The incidence of gastric cancer and the number of gastric cancer patients that a surgeon treats annually are so vastly different between countries and regions that it is not easy to define which type of gastric cancer surgery should be considered the global standard. Nevertheless, a consensus that D2 dissection is the most appropriate way to treat resectable advanced gastric cancer has arguably been reached after long-term follow-up and flexible interpretation of the Dutch D1 versus D2 trial and evidence from the Japan Clinical Oncology Group 9501 study which denied survival benefit of more extensive lymphadenectomy. After the Japan Clinical Oncology Group 9501 trial, surgeons gradually lost interest in attempting to improve survival through extended resection and instead began to expend greater resources on establishing and standardizing the technique of minimally invasive surgery and proving its oncological non-inferiority compared with the conventional approach. Laparoscopic distal gastrectomy has become an option in daily clinical practice in the Far East, and more demanding procedures such as laparoscopic total gastrectomy and laparoscopic surgery for advanced gastric cancer are currently being explored in clinical trials from the viewpoint of both safety and oncological feasibility. In addition, the high proportion of early-stage cancer in the Far East prompted surgeons to develop limited surgery such as proximal gastrectomy and pyloruspreserving gastrectomy, which warrant further evaluation regarding benefits in terms of postoperative nutritional state and/or quality of life measurements to convince the rest of the world.

Safety and feasibility of laparoscopic gastrectomy accompanied by D1+ lymph node dissection for early gastric cancer in elderly patients

“…This raised a simple question: Is aggressive LN dissection necessary in elderly patients? The impact of LG or LN dissection on the outcome of gastric cancer has been previously discussed (25,26). Our long-term outcomes demonstrated no significant differences in either OS or RFS between the two groups.…”

Anti-tumor effects of lidocaine on human gastric cancer cells in vitro

“…Besides, the effect of nursing practices on clinical treatment of gastric cancer has also received an increasing atten-tion. A lot of evidence suggested that incorporating holistic nursing of psychological and physical components into routine ward nursing could effectively improve the quality of life and enhance the survival time for patients (11,12). The molecular mechanisms underlying growth and metastasis of gastric cancer remain unknown.…”

The composition and variation of the BCR CDR3s in gastric cancer

“…GC is biologically and genetically heterogeneous with a poorly understood carcinogenesis at the molecular level. Despite there were many prognostic, predictive, and therapeutic biomarkers: HER2, E-cadherin, fibroblast growth factor receptor, mammalian target of rapamycin, and hepatocyte growth factor receptor as well as sections on microRNAs, long noncoding RNAs, matrix metalloproteinases, PD-L1, Baniak et al investigated to date ( 12 ), GC continues to be detected at an advanced stage with resultant poor clinical outcomes ( 13 , 14 ).…”