Best practice in macroscopic examination of gastric resections

Gastric cancer is one of the most common cancers worldwide, with a frequency that varies greatly across different geographic locations. Over recent decades there has been a marked increase in cancers of the oesophagogastric junction, but gastric cancers have shown a decrease in worldwide incidence. However, they still account for 3-10% of all cancer-related deaths. There has been a steady improvement in prognosis in countries such as Japan, predominantly due to screening programmes and early detection, but this has not been seen in Europe and North America. At present the only curative treatment for gastric cancer is complete surgical resection of the primary tumour, with appropriate lymphadenectomy. High quality histology reports are necessary to provide information on diagnosis, prognosis and future management. They can also be important with regard to research, audit and epidemiological studies. This review examines the evidence-based guidelines for macroscopic examination and block selection for gastric carcinomas, with a brief comment on new surgical techniques.