Strengthening the quality control of radical gastrectomy for locally advanced gastric cancer

Abstract

The extent of gastrectomy and lymphadenectomy for locally advanced gastric cancer were revised in the 5th Japanese gastric cancer treatment guidelines. The 2018 edition of the Chinese Society of Clinical Oncology (CSCO) guidelines for the diagnosis and treatment of gastric cancer were revised according to the Japanese guidelines. The following items are extremely important for the quality control of radical gastrectomy: lymphadenectomy is carried out straitly according the guidelines, ex vivo lymph nodes are dissected from the specimen by surgeons according the different lymph node groups and the pathological report should contains the number of examined and metastatic lymph nodes of different groups individually. The number of dissected/examined lymph nodes has significant impacts on patients′ pathologic staging. In order to avoid the migration of staging, 30 and more lymph nodes should be dissected and examined. The experience of surgeons, training and operation volumes are decisive factors for the quality of operation. Centralization and specialization of gastric cancer treatment are shortcuts to improve the quality of radical gastrectomy. Key words: Gastric neoplasms; Advanced phase; Treatment; Radical resection; Quality control