Journal List > Korean J Gastroenterol > v.57(6) > 1006819

Seo and Yoon: Individualized Surgery for Gastric Cancer

Abstract

Recently, tailored and multidisciplinary treatment of gastric cancer was emerging in the field of clinical oncology. Gastric cancer is the most frequently diagnosed cancer in Korea. Surgery is the only possible curative procedure, and extensive gastrectomy and D2 lymph node dissection has been accepted as standard treatment in all gastric cancer patients until recently. In early gastric cancer, many researchers established the indications of limited surgery including endoscopic mucosal resection based on various well-collected retrospective data. Limited surgery and minimally invasive surgery contribute to quality of life in gastric cancer patients. In advanced gastric cancer, eastern surgeons believe that D2 lymph node dissection is standard treatment if done by credential surgeons in specialized centers despite of different opinion of western surgeon. In addition, adjuvant chemotherapy after good local control by D2 dissection has gained survival benefit rather than D2 dissection alone in randomized trials. In conclusion, present confronted issue is to establish tailored treatments of individualized patients through extent of disease in gastric cancer patients.

References

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Table 1.
Prospective Randomized Controlled Trials about Comparison of D1 and D2
Study Period No. of participant Extent of LN No. of Morbidity Mortality 5YSR
Study Period surgeon dissection patients (%) (%) (%)
Cuschieri (MRC trial) 1987-1994 32 D1 200 28 6.5 435
      D2 200 46 13 33
Bonenkamp (Dutch trial) 1989-1993 80 D1 380 25 4 45
      D2 331 43 10 47
Wu (Taipei) 1993-1999 3 D1 110 7 0 53.6
      D3 (D2) 111 17 0 59.5

LN, lymph node; YSR, year survival rate; MRC, medical research council.

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