[Surgical treatment for curable and incurable recurrent gastric cancer]

Recurrent gastric cancer(RGC)after curative resection(R0)is difficult to treat and is often incurable. In such case, patients undergo palliative therapy. However, a small number of patients with RGC can be cured by multimodality therapy. The impact of surgical treatment on patient outcome was studied for each RGC pattern of recurrence. Dissection of GC in combination with lymphadenectomy is a promising treatment strategy for patients with P0CY1 or P1 GC. In contrast, there is no viable treatment option for patients with P2 or P3 GC. A clinical trial is currently ongoing in order to develop new treatment approaches for such patients. In patients presenting with metachronous liver metastasis or para-aortic lymph node(PAN) recurrence, liver resection or PAN dissection are good options and long-term survival is expected if the primary tumor is controlled, if there are no other remote metastases, and if the recurrent lesion is limited. Complete resectability of the tumor is the only significant prognostic factor. In cases where complete resection is not possible, palliative surgery and non-surgical approaches yield similar patient outcomes. In conclusion, RGC is commonly treated with systemic chemotherapy. However, surgery, as part of multimodality therapy, should be considered in cases where complete resection of RGC is achievable.