The
gastric cancer is the most common
cancer in Korea. The only treatment modality showing improved survival for
gastric cancer is curative surgical resection, which comprises the resection of stomach, proper
lymphadenectomy, and reconstruction. However, specific
surgical procedures should be decided according to the location of the
cancer, advancement of the
tumor, and patients condition. Surgical treatment for
gastric cancer has been developed toward two directions that are minimal invasive surgery for early
gastric cancer and multi-disciplinary approach for advanced
gastric cancer. Laparoscopic surgery for early
gastric cancer has been accepted for
minimally invasive surgery. Moreover, the advancement of diagnostic tools to assess
biological aggressiveness of the
tumor enables physicians to perform endoscopic resection or minimized resection for early
gastric cancer. Recently, surgeons try to extend the application of laparoscopic gastric resection and D2
lymphadenectomy to advanced
gastric cancer. However, technical and oncological evidences based on clinical trials should be filed up before adopting it as a standard
therapy. In case of advanced
gastric cancer, in addition to radical surgery, various treatment modalities including
chemotherapy, radiation, and molecular target
therapy also have been applied in many clinical trials. However, it should be stressed that a prerequisite for precise evaluation of the efficacy of these combined treatment modalities would be the standardization of
surgical procedure.