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  4. Vol 6, Issue 1, 2025

Advances and Emerging Trends in Surgical Management of Gastric Cancer: A Contemporary Review

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DOI: 10.23977/tranc.2025.060112 | Downloads: 4 | Views: 873

Author(s)

Kaihu Fan 1, Jialun He 1, Genyuan Peng 1, Xiaojing Zou 2

Affiliation(s)

1 Department of General Surgery, Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, China
2 Department of Gastroenterology, Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, China

Corresponding Author

Xiaojing Zou

ABSTRACT

Gastric cancer remains one of the most significant global health burdens, representing the fifth most common malignancy and the third leading cause of cancer-related death worldwide. Despite gradual declines in incidence in several regions, it continues to be highly prevalent in East Asia, Eastern Europe, and parts of South America. Surgical resection remains the only potentially curative treatment, but the last two decades have witnessed transformative changes in surgical management, perioperative care, and integration with multimodal therapy. Conventional open gastrectomy has evolved toward minimally invasive laparoscopic and robotic approaches, while refinements in lymphadenectomy, function-preserving resections, and organ-sparing strategies aim to balance oncological radicality with improved postoperative quality of life. Furthermore, multimodal integration with perioperative chemotherapy, immunotherapy, and targeted therapy is reshaping surgical decision-making. Advances in perioperative care, such as Enhanced Recovery After Surgery (ERAS) protocols, combined with novel technologies including fluorescence-guided surgery, artificial intelligence, and 3D simulation, are further optimizing outcomes. This review provides a comprehensive synthesis of these advances, critically analyzing evidence from randomized controlled trials, cohort studies, and international guidelines. We emphasize ongoing controversies, global variations in practice, and future directions, arguing that surgical management of gastric cancer is moving toward a more individualized, minimally invasive, and precision-driven approach integrated within multimodal frameworks.

KEYWORDS

Gastric Cancer, Gastrectomy, Minimally Invasive Surgery, Robotic Surgery, Lymphadenectomy, Perioperative Management, Multimodal Therapy

CITE THIS PAPER

Kaihu Fan, Jialun He, Genyuan Peng, Xiaojing Zou, Advances and Emerging Trends in Surgical Management of Gastric Cancer: A Contemporary Review. Transactions on Cancer (2025) Vol. 6: 94-100. DOI: http://dx.doi.org/10.23977/tranc.2025.060112.

REFERENCES

[1] Li G Z, Doherty G M, Wang J. Surgical management of gastric cancer: a review[J]. JAMA surgery, 2022, 157(5): 446-454.
[2] Mocan L. Surgical management of gastric cancer: a systematic review[J]. Journal of clinical medicine, 2021, 10(12): 2557.
[3] Weledji E P. The principles of the surgical management of gastric cancer[J]. IJS Oncology, 2017, 2(7): e11.
[4] Yamamoto M, Rashid O M, Wong J. Surgical management of gastric cancer: the East vs. West perspective[J]. Journal of gastrointestinal oncology, 2015, 6(1): 79.
[5] Mahar A L, Brar S S, Coburn N G, et al. Surgical management of gastric perforation in the setting of gastric cancer[J]. Gastric Cancer, 2012, 15(Suppl 1): 146-152.
[6] Rosa F, Schena C A, Laterza V, et al. The role of surgery in the management of gastric cancer: state of the art[J]. Cancers, 2022, 14(22): 5542.
[7] Thrumurthy S G, Chaudry M A, Hochhauser D, et al. The diagnosis and management of gastric cancer[J]. Bmj, 2013, 347.
[8] Thrumurthy S G, Chaudry M A, Chau I, et al. Does surgery have a role in managing incurable gastric cancer?[J]. Nature reviews Clinical oncology, 2015, 12(11): 676-682.
[9] Lee J H, Kim K M, Cheong J H, et al. Current management and future strategies of gastric cancer[J]. Yonsei medical journal, 2012, 53(2): 248-257.
[10] Coburn N, Cosby R, Klein L, et al. Staging and surgical approaches in gastric cancer: A systematic review[J]. Cancer treatment reviews, 2018, 63: 104-115.
[11] Irino T, Matsuda S, Wada N, et al. Essential updates 2019/2020: Perioperative and surgical management of gastric cancer[J]. Annals of gastroenterological surgery, 2021, 5(2): 162-172.
[12] Narayan R R, Poultsides G A. Advances in the surgical management of gastric and gastroesophageal junction cancer[J]. Translational Gastroenterology and Hepatology, 2021, 6: 16.
[13] Venerito M, Ford A C, Rokkas T, et al. Prevention and management of gastric cancer[J]. Helicobacter, 2020, 25: e12740.
[14] Kitagawa Y, Fujii H, Kumai K, et al. Recent advances in sentinel node navigation for gastric cancer: a paradigm shift of surgical management[J]. Journal of surgical oncology, 2005, 90(3): 147-151.
[15] Jin P, Ji X, Tian Y. Surgical management of oligometastatic disease in gastric cancer[J]. Clinics and Research in Hepatology and Gastroenterology, 2020, 44(5): 638-645.
[16] Shen L, Shan Y S, Hu H M, et al. Management of gastric cancer in Asia: resource-stratified guidelines[J]. The Lancet Oncology, 2013, 14(12): e535-e547.
[17] Japanese Gastric Cancer Association jgca@ koto. kpu-m. ac. jp. Japanese gastric cancer treatment guidelines 2021[J]. Gastric Cancer, 2023, 26(1): 1-25.
[18] Chen T, Yan D, Zheng Z, et al. Evolution in the surgical management of gastric cancer: is extended lymph node dissection back in vogue in the USA?[J]. World Journal of Surgical Oncology, 2017, 15(1): 135.
[19] Songun I, Putter H, Kranenbarg E M K, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial[J]. The lancet oncology, 2010, 11(5): 439-449.
[20] Brenkman H J F, Haverkamp L, Ruurda J P, et al. Worldwide practice in gastric cancer surgery[J]. World journal of gastroenterology, 2016, 22(15): 4041.
[21] Wang X N, Liang H. Some problems in the surgical treatment of gastric cancer[J]. development, 2010, 7: 6.
[22] Marano L, Verre L, Carbone L, et al. Current trends in volume and surgical outcomes in gastric cancer[J]. Journal of Clinical Medicine, 2023, 12(7): 2708.
[23] Hoshi H. Management of gastric adenocarcinoma for general surgeons[J]. Surgical Clinics, 2020, 100(3): 523-534.
[24] Duan Y, Xu Y, Dou Y, et al. Helicobacter pylori and gastric cancer: mechanisms and new perspectives[J]. Journal of Hematology & Oncology, 2025, 18(1): 10.
[25] Chen Y, Wang B, Zhao Y, et al. Metabolomic machine learning predictor for diagnosis and prognosis of gastric cancer[J]. Nature communications, 2024, 15(1): 1657.
[26] Yu X, Zhang Y, Luo F, et al. The role of microRNAs in the gastric cancer tumor microenvironment[J]. Molecular cancer, 2024, 23(1): 170.
[27] Zhang X, Wang J, Wang G, et al. First-line sugemalimab plus chemotherapy for advanced gastric cancer: the GEMSTONE-303 randomized clinical trial[J]. Jama, 2025, 333(15): 1305-1314.
[28] Khosravi M, Jasemi S K, Hayati P, et al. Transformative artificial intelligence in gastric cancer: Advancements in diagnostic techniques[J]. Computers in Biology and Medicine, 2024, 183: 109261.
[29] Matsubayashi C O, Cheng S, Hulchafo I, et al. Artificial intelligence for gastric cancer in endoscopy: from diagnostic reasoning to market[J]. Digestive and Liver Disease, 2024, 56(7): 1156-1163.

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