Subtotal gastrectomy for gastric cancer

Area of Science:

• Surgical Oncology
• Gastroenterology

Background:

• Gastric carcinoma incidence is rising globally due to population aging.
• Surgical resection remains the only curative treatment for gastric cancer.
• Gastric cancer surgery demands specialized skills and adherence to evolving oncological principles.

Purpose of the Study:

• To clarify the landmarks of subtotal gastrectomy for gastric cancer.
• To define the role of subtotal gastrectomy in comparison to other treatments.
• To address controversies in resection extent and lymph node dissection for middle-third gastric cancer.

Main Methods:

• Review of current literature on gastric cancer surgical techniques.
• Analysis of oncological principles guiding gastric cancer surgery.
• Comparison of subtotal gastrectomy with total gastrectomy and other resection methods.

Main Results:

• Subtotal gastrectomy is the preferred treatment for middle and distal gastric cancer, offering comparable survival and better functional outcomes than total gastrectomy.
• Lymph node metastasis is the primary prognostic factor in resectable gastric cancer.
• The extent of gastric resection and lymph node dissection is patient- and disease-tailored, ranging from endoscopic to extended resections.

Conclusions:

• Subtotal gastrectomy provides optimal outcomes for specific gastric cancer locations and stages.
• Lymph node dissection is critical but challenging, requiring meticulous surgical technique.
• Further clarification on optimal resection and lymph node dissection for middle-third gastric cancer is needed.