Worldwide practice in gastric cancer surgery

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Gastric cancer surgery remains a cornerstone of treatment.
• Understanding current global surgical practices is crucial for advancing patient care.

Purpose of the Study:

• To evaluate the current worldwide status and preferences in gastric cancer surgery.
• To identify trends in surgical approaches, lymphadenectomy, and neoadjuvant treatment.

Main Methods:

• An international cross-sectional web-based survey was distributed to upper gastro-intestinal surgeons.
• Participants provided data on hospital volume, neoadjuvant therapy, surgical approach, lymphadenectomy extent, and anastomotic techniques.
• The survey targeted members of the International Gastric Cancer Association.

Main Results:

• A 37% response rate (227/615) was achieved, with most respondents from Asia (54%) and high annual gastrectomy volume (>21/year, 79%).
• Neoadjuvant chemotherapy was utilized by 73% of surgeons.
• Open surgery dominated for advanced distal and total gastrectomies (91%, 94%), while minimally invasive approaches were preferred for early distal (65%) and early total gastrectomies in Asia (63%).
• D1+ lymphadenectomy was favored for early gastric cancer, and D2 for advanced stages.

Conclusions:

• Significant global variation exists in surgical preferences for gastric cancer.
• Neoadjuvant chemotherapy is widely adopted, but minimally invasive surgical techniques are not yet universally implemented.
• Future research should focus on standardizing minimally invasive approaches and evaluating their oncological outcomes.