[Open surgery]

There are many advantages in the open surgery, which is a standard approach for gastric cancer surgery and recommended as a daily medical treatment in Japanese gastric cancer treatment guidelines now. A standard gastrectomy and an extended surgery, such as dissection of the abdominal para-aortic lymph nodes, resection of caudal pancreas and spleen, pancreaticoduodenectomy, gastrectomy for advanced gastric cancer (AGC) with esophageal invasion, hepatectomy for liver metastasis, should be performed by the open surgery. There are also advantages in Stage IV gastric cancer patients after preoperative chemotherapy and patients with remnant stomach cancer. A standard gastrectomy is a principal surgical procedure performed with curative intent. It involves resection of at least two-third of the stomach with a D2 lymphadenectomy. The strategies and results of the extended surgical treatment for AGC were explained but they were considered an experimental approach yet. There was no evidence suggesting the effectiveness of the extended surgery, therefore strategies of multidisciplinary treatment including extended surgery should be verified based on scientific evidence.