[Changes in surgical treatment for gastric cancer]

Gastrectomy for gastric cancer was carried out successfully for the first time by Professor T. Billroth in 1881. Since then, surgical treatment for gastric cancer has come into worldwide use. In Japan, since the establishment of the Japanese Research Society for Gastric Cancer in 1962, extended radical gastrectomy, which included extended lymphadenectomy and combined resection of other organs, was the main surgical strategy to increase the radical cure rate for gastric cancer. Recently, however, as the number of cases of early gastric cancer has increased, rational surgery (type-oriented surgery) has been increasingly performed in consideration of the quality of life after surgery. Specifically, various limited operations for small early gastric cancer, and super-extended surgery for advanced gastric cancer have been carried out. To perform limited surgery for gastric cancer in which radicality is not compromised, preoperative and intraoperative diagnosis of the extent of cancerous lesions must be performed accurately, and sufficient clinicopathological knowledge of the extension of gastric cancer is indispensable. Moreover, minimally invasive surgical techniques have been developed in recent years. Every effort should be made to perform rational surgery for gastric cancer on the basis of studies in past decades.