Curative surgery - the complete removal of the tumor (R0 resection) - has long been considered the treatment of choice and the only treatment modality able to provide cure in localized gastric cancer. But until now, the optimal extent of this surgical resection still remains highly debated. Several factors including tumor stage and difficulties in accurate pre-, or intra-operative staging-prediction, surgical complications, risks of residual disease and recurrence, as well as quality of life (QOL) differentially influence and complicate the selection of appropriate extent of surgery.

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