Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.

This issue of Surgical Oncology Clinics of North America, Guest Edited by Neal Wilkinson, MD, is devoted to the Management of Gastric Cancer. Articles in this issue will focus on Epidemiology; Genetics and Prophylactic Surgery; Endoscopic Diagnosis & Staging; Gastric Stromal Tumors (GIST); Management of Early Stage Gastric Cancer; Endoscopic Mucosal Resection (EMR); Tailored Lymphadenectomy; Laparoscopic Resection Gastric Cancer - Western Experience; Gastric Cancer - Eastern Experience; Update of Gastric Cancer Clinical Trials; Preoperative and Postoperative Chemotherapy for Gastric Cancer; and Phase I and II Clinical Trials.

Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.

This book presents surgical techniques and detailed illustrations of laparoscopic gastrectomy for gastric cancer, focusing on effective, concise steps and techniques. It describes in detail the perigastric anatomy, and the incidences of each anatomical structure are analyzed statistically. It also discusses lessons learned and best practices in the management of gastric cancer patients, and includes video captures of precise operational techniques -essential resources for gastrointestinal laparoscopic surgeons. Given its close connection to clinical practice, it offers a valuable reference work for general surgeons and residents.​

One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.

Presented by the American College of Surgeons and the Alliance for Clinical Trials in Oncology, the first comprehensive, evidence-based examination of cancer surgery techniques as standards distills the well-defined protocols and techniques that are critical to achieve optimal outcomes in a cancer operation. This unique, one of a kind collaboration between the American College of Surgeons and the Alliance for Clinical Trials in Oncology focuses on best practices and state-of-the-art methodologies. Operative Standards for Cancer Surgery clearly describes the surgical activities that occur between skin incision and skin closure that directly affect cancer outcomes.

The purpose of this book is twofold: First, it provides an up-to-date overview of the field of surgical oncology for surgeons in training. Particular attention is devoted to the principles of surgery, but important aspects of radiation and medical oncology are also discussed. Furthermore, diagnostic, staging, and treatment algorithms are presented that will offer invaluable assistance in management decision making. The second aim of the book is to offer a comprehensive reference source on the role of surgery in curative and palliative management for medical and radiation oncologists (in practice and in training) and other healthcare professionals involved in the care of cancer patients. The full range of cancer types is covered in a practical, multidisciplinary approach, and additional chapters are devoted to pediatric malignancies, the role of new surgical technologies, and surgical emergencies. ​

This issue of Surgical Oncology Clinics of North America, guest edited by Dr. David Ilson, is devoted to Topics in Esophageal and Gastric Cancers. Dr. Ilson has assembled expert authors to review the following topics: Minimally Invasive Surgery: The Emerging Role in Esophageal and Gastric Cancer; Novel Targeted Therapies in Esophagogastric Cancer; The Role of Nutritional Support in Esophagogastric Cancer; Screening and Preventive Strategies in Esophagogastric Cancer; Current Progress in HER2 Targeted Therapies in Esophagogastric Cancer; The Role of Radiotherapy in Esophagogastric Cancer; Endoscopic Management of Early Esophagogastric Cancer; Current Progress in the Adjuvant Treatment of Gastric Cancer; Controversies and Consensus in Preoperative Therapy of Esophageal and GE Junction Cancers; Issues in the Management of Esophagogastric Cancer in Geriatric Patients; East versus West: The Asian Perspective on the Surgical and Adjuvant Management of Esophagogastric Cancer; The Current Status of Immunotherapies in Esophagogastric Cancer; and more!

A definitive, accessible, and reliable resource which provides a solid foundation of the knowledge and basic science needed to hone all of the core surgical skills used in surgical settings. Presented in a clear and accessible way it addresses the cross-specialty aspects of surgery applicable to all trainees.

This third edition manual provides a comprehensive, insightful, evidenced-based review of general surgical oncology and serves as a valuable resource for general surgeons in training, practicing general surgeons, and surgical oncologists. The volume describes a multidisciplinary approach that integrates clinical, radiologic, and pathologic data in formulating practical clinical management, and offers a practical approach to the most common situations when treating cancer patients. Each chapter focuses on an individual malignancy and describes the presentation of the malignancy, integrated management based on stage, landmark trials, and suggestions for who to discuss at multidisciplinary cancer conferences. Multiple tables in each chapter provide a concise yet comprehensive summary of the current status of the field. Clinical “pearls” or tips and tricks from high volume surgeons at the University of Toronto are also discussed. The third edition of the Surgical Oncology Manual will serve as a critical resource for general surgeons in training and practicing surgeons dealing with this challenging field.