Japanese gastric cancer treatment guidelines 2018 (5th edition)

要旨

M1: metastasis outside the regional lymph nodes (including CY1).Stage grouping: See Table 1. Surgery Types and definitions of gastric surgery Standard gastrectomy and non-standard gastrectomy in surgery with curative intentStandard gastrectomy Standard gastrectomy is the principal surgical procedure performed with curative intent.It involves resection of at least two-thirds of the stomach with a D2 lymph node dissection (refer to the section of "lymph node dissection" and Fig. 2 and 5 for the definition of D-categories). Non-standard gastrectomyIn non-standard gastrectomy, the extent of gastric resection and/or lymphadenectomy is altered according to tumor stages.It includes modified surgery and extended surgery. Modified surgeryThe extent of gastric resection and/or lymphadenectomy is reduced (D1, D1+, etc.) compared to standard surgery.Extended surgery (1) Gastrectomy with combined resection of adjacent involved organs.(2) Gastrectomy with extended lymphadenectomy exceeding D2. Non-curative surgeryNon-curative surgery is offered to the patients who are considered to be incurable.It can be semi-classified into either palliative surgery or reduction surgery depending on the aim of surgery.

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