In
Korea,
gastric cancer ranks second among all the
causes of death from
cancer, and is the most frequently diagnosed
cancer.
Surgery is the only possible curative
treatment, and results of
gastrectomy have improved throughout the years with
respect to
survival,
morbidity, and postoperative
mortality. Extent of gastric resection and type of reconstruction can
affect the
survival and postoperative
quality of life (QOL) in
gastric cancer patients. Various kinds of reconstruction, especially after total
gastrectomy, has been applied to improve the QOL. Eastern, especially Korean and
Japanese,
surgeons differ in their approaches to
lymph node dissection during
surgery for
stomach cancer compared to Western
surgeons. D2
lymph node dissection has not gained widespread popularity in the West, because improved
survival has never been demonstrated in randomized trials. However, Korean
surgeons believe that D2
dissection is not a dangerous
procedure if done by
specialists in specialized centers. It is still a matter of question if
chemoradiotherapy after D2
dissection can improve the results of D2
dissection alone. However, the more urgent issue is to establish the standard
adjuvant chemotherapy protocol after the good local control by
surgery (D2 or more).