Korean J Gastroenterol.  2009 Aug;54(2):83-98. 10.4166/kjg.2009.54.2.83.

Surgical Treatment of Gastric Carcinoma

Affiliations
  • 1Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. chpark@catholic.ac.kr

Abstract

The gastric cancer is the most common cancer in Korea. The only treatment modality showing improved survival for gastric cancer is curative surgical resection, which comprises the resection of stomach, proper lymphadenectomy, and reconstruction. However, specific surgical procedures should be decided according to the location of the cancer, advancement of the tumor, and patients' condition. Surgical treatment for gastric cancer has been developed toward two directions that are minimal invasive surgery for early gastric cancer and multi-disciplinary approach for advanced gastric cancer. Laparoscopic surgery for early gastric cancer has been accepted for minimally invasive surgery. Moreover, the advancement of diagnostic tools to assess biological aggressiveness of the tumor enables physicians to perform endoscopic resection or minimized resection for early gastric cancer. Recently, surgeons try to extend the application of laparoscopic gastric resection and D2 lymphadenectomy to advanced gastric cancer. However, technical and oncological evidences based on clinical trials should be filed up before adopting it as a standard therapy. In case of advanced gastric cancer, in addition to radical surgery, various treatment modalities including chemotherapy, radiation, and molecular target therapy also have been applied in many clinical trials. However, it should be stressed that a prerequisite for precise evaluation of the efficacy of these combined treatment modalities would be the standardization of surgical procedure.

Keyword

Gastric adenocarcinoma; Surgical treatment; Minimal invasive surgery; Multidisciplinary approach

MeSH Terms

Carcinoma/*surgery
Gastrectomy
Gastroenterostomy
Humans
Laparoscopy
Lymph Node Excision
Neoplasm Staging
Stomach Neoplasms/*surgery

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