Influence of surgery on outcomes in gastric cancer.

Surgery is the only possible curative treatment for gastric cancer. Although outcomes over the years have improved, there are still many controversies in the treatment of gastric cancer. One highly controversial topic is the extent of the operation. Results of recently performed large randomized studies may cause some policies to change. This article addresses the influence of surgery on outcomes of D1-D2 dissections, total versus subtotal gastrectomy, and pancreas and spleen resection and staging. Furthermore, several aspects of patient selection, the surgeon as a prognostic factor, noncurative treatment, and chemotherapy are discussed.