Current Standards of Surgical Management of Gastric Cancer: an Appraisal

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2023 Feb 6

PMID 36745231

Authors

Christian T J Magyar

Ankit Rai

Karl R Aigner

Parvezikbal Jamadar

Tung Y Tsui

Beat Gloor

Somprakas Basu

Yogesh K Vashist

Affiliations

Soon will be listed here.

Abstract

Purpose: Gastric cancer (GC) is the fifth most common malignancy worldwide and portends a grim prognosis due to a lack of appreciable improvement in 5-year survival. We aimed to analyze the available literature and summarize the current standards of surgical care for curative and palliative intent treatment of GC.

Methods: We conducted a systematic search on the PubMed database for studies on the management of GC.

Results: Endoscopic resection is an acceptable treatment option for T1a tumors. The role of optimal resection margin for GC remains unclear. D2 lymph node dissection remains the standard of care with splenectomy needed selectively for splenic hilum involvement. A distal pancreatic resection should be avoided. The advantage of bursectomy and omentectomy in GC surgery is not clear. Multi-visceral resection may be considered for locally advanced GC in carefully selected patients. Minimally invasive approaches are non-inferior to open surgery. Surgery should be abandoned prior even in metastatic GC within the frame of multimodal therapy approach.

Conclusion: Various trials have conclusively shown improved patient outcomes when well-established surgical standards are followed.

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