1. Literature summary

    • The extent of the resection can already be planned before surgery based on the histomorphological  Laurén classification (1, 2).
    • In adenocarcinoma of the gastroesophageal junction (AEG II/III), particularly in locally advanced tumors and following preoperative chemotherapy, frozen section of the proximal resection margin should be obtained (5).
    • Resection of an adequate number of lymph nodes, even if benign, (7) may be beneficial.
    • At present, the lack of randomized trials does not allow assessment of the role of laparoscopic resection (1, 3).
    • The postulated benefits of preserving duodenal transit have not been proven. Pouch formation/gastric replacement is advocated, although few meaningful trials are available (2).
  2. Ongoing trials on this topic

  3. References on this topic

      1. Brennan MF (2005): Current status of surgery for gastric cancer: a review. Gastric Cancer 8:64-70
      2. Chin AC, Espat NJ (2003): Total gastrectomy: options for restoration of gastrointestinal conituitiy. Lancet Oncol 4:271-276
      3. Huscher CG, Mingoli A, Szarzini G et al. (2007): Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series. Am J Surg 194:839-844
      4. Lehnert T, Buhl K (2004): Techniques of reconstruction after total gastectomy for cancer. Br J Surg 91:528-539
      5. Meyer HJ, Opitz G (2007): Aktuelle chirurgische Therapiestrategien beim Magenkarzinom. Verdauungskrankheiten 25:112-121
      6. Mönig SP, Lübke T, Baldus SE (2005): Primärtherapie des Magenkarzinoms. Onkologe 11:630-639
      7. Siewert JR, Kestlmeier R, Busch R et al. (1996): Benefits of D2 lymph node dissection for patients with gastric cancer and pN0 and pN1 lymph node metastases. Br J Surg 83:1144-1147

Merga ZC, Lee JS, Gong CS. Outcomes of Gastrectomy for Gastric Cancer in Patients Aged >80 Years

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