[Surgical treatment of far-advanced gastric cancer]

Surgical treatment of far-advanced gastric cancer should be categorized as part of a multidisciplinary treatment. Its therapeutic principles may be summarized as follows: survival should be expected; operative death must be avoided; any operation promoting the growth of cancer should be avoided; oral intake should be made possible, pain should be eased; and the main focus must be removed as far as possible. In the cases with positive peritoneal dissemination, even at P3, a significant extension of life is recognized in the palliative gastrectomy group as compared with the non-resected group. However, considering the postoperative length of life, palliative gastrectomy seems applicable to cases of P1, H1, partly to H2, n3(+), and S3, but in more advanced cases, it was learned essential to determine the surgical method in consideration of the nature of the cancer in the individual cases.