Editorial
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Jul 21, 2010; 16(27): 3358-3370
Published online Jul 21, 2010. doi: 10.3748/wjg.v16.i27.3358
R0 resection in the treatment of gastric cancer: Room for improvement
Alberto Biondi, Roberto Persiani, Ferdinando Cananzi, Marco Zoccali, Vincenzo Vigorita, Andrea Tufo, Domenico D’Ugo
Alberto Biondi, Emergency and General Surgery Unit, Fondazione IRCCS “Ca’ Grande” Policlinico Maggiore, Via F. Sforza 35, 20122 Milan, Italy
Roberto Persiani, Ferdinando Cananzi, Marco Zoccali, Vincenzo Vigorita, Andrea Tufo, Domenico D’Ugo, First General Surgery Unit, Department of Surgery, Catholic University, Rome - Largo A. Gemelli 8, 00168 Rome, Italy
Author contributions: Biondi A, Persiani R, Cananzi F, Zoccali M, Vigorita V, Tufo A and D’Ugo D equally participated in the conception, design, and drafting of this article; all authors revised the article critically for important intellectual content and gave final approval of the version to be published.
Correspondence to: Alberto Biondi, MD, Emergency and General Surgery Unit, Fondazione IRCCS “Ca’ Grande” Policlinico Maggiore, Via F. Sforza 35, 20122 Milan, Italy. biondi.alberto@tiscali.it
Telephone: +39-2-55033298 Fax: +39-2-55033468
Received: February 10, 2010
Revised: March 18, 2010
Accepted: March 25, 2010
Published online: July 21, 2010
Abstract

Gastric carcinoma is one of the most frequent malignancies in the world and its clinical behavior especially depends on the metastatic potential of the tumor. In particular, lymphatic metastasis is one of the main predictors of tumor recurrence and survival, and current pathological staging systems reflect the concept that lymphatic spread is the most relevant prognostic factor in patients undergoing curative resection. This is compounded by the observation that two-thirds of gastric cancer in the Western world presents at an advanced stage, with lymph node metastasis at diagnosis. All current therapeutic efforts in gastric cancer are directed toward individualization of therapeutic protocols, tailoring the extent of resection and the administration of preoperative and postoperative treatment. The goals of all these strategies are to improve prognosis towards the achievement of a curative resection (R0 resection) with minimal morbidity and mortality, and better postoperative quality of life.

Keywords: Gastric cancer; R0 resection; Total gastrectomy; Lymph node dissection; Adjuvant therapy; Preoperative therapy