A decade in gastric cancer curative surgery: Evidence of progress (1999-2009)

Table 2 Current grade I A recommendations for non-metastatic gastric cancer surgery

Topic	Recommendation	Ref.
Traditional controversies
Extension of resection	Subtotal gastrectomy with 5 cm negative margins is sufficient for the curative treatment of distal tumors	[1]
	Prophylactic splenectomy is not necessary for cardia tumors either	[25-27]
Extension of lymphadenectomy	D2 nodal dissection with spleno-pancreasectomy does not provide any survival benefit and increases post-operative morbidity and mortality rates	[2-3]
	Pancreas-preserving D2 nodal dissection increases survival rates without any significant post-operative morbidity and mortality	[44]
	Para-aortic nodal dissection (in addition to D2 lymphadenectomy) does not improve the survival rate in curable diasease	[45]
Surgery in multimodal strategy
Pre-operative chemotherapy	Pre-operative chemotherapy is associated to an increase in survival rates	[121,122]