Controversies in the Surgical Management of Gastric Cancer

Authors:
David A. KoobyFrom Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.

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Daniel G. CoitFrom Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.

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Volume/Issue:
Volume 1: Issue 1
Online Publication Date:
Mar 2003
DOI:
https://doi.org/10.6004/jnccn.2003.0012
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Although the incidence of gastric adenocarcinoma in the United States has declined steadily since the early 1900s, it remains a significant health problem. Progress has been made during the past few decades in several areas: Lymph node staging has been refined, perioperative mortality has fallen, and plausible adjuvant therapy has emerged. Currently, complete surgical resection is the mainstay of therapy because it is the only potentially curative option; however, considerable controversy remains regarding the specifics of a surgical approach. This article examines 4 major controversies in the management of gastric cancer: extent of gastric resection, role of extended lymph node dissection, value of elective splenectomy for proximal gastric lesions, and current state of adjuvant therapy. Pertinent retrospective and prospective studies are reviewed to help formulate meaningful conclusions.

Correspondence: Daniel G. Coit, Memorial Sloan-Kettering Cancer Center, Department of Surgery, 1275 York Avenue, New York, NY 10021. E-mail: coitd@mskcc.org
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Copyright:
Copyright © 2003 by the National Comprehensive Cancer Network 2003
Page Numbers:
10
Article Category:
Research Article
Received:
05 Sep 2002
Accepted:
20 Sep 2002
Print Publication Date:
01 Mar 2003
Online Publication Date:
Mar 2003
Keywords:
Stomach; neoplasms; gastrectomy; lymph node excision; splenectomy; adjuvant chemotherapy
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