[Surgery of stomach cancer--an assessment of current status]

Surgical strategy for gastric carcinoma consists of total gastrectomy as a rule combined with extended lymphadenectomy. For small tumors of the intestinal type located in the distal stomach distal gastric resection can be taken into consideration. In case of a high risk patient endoscopic polypectomy of a polypoid early gastric carcinoma can be sufficient. If the operation is done for cure intraoperative radiotherapy is employed within prospective trials in order to prevent local recurrence. Extended resections prolong survival time only if curativity will be achieved. For palliative situations procedures including removal of the tumor have better results with regard to quality of life and survival than bypass methods.