Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2009.0104

COMMENTARY

Abstract
The estimated increase by 55% in the incidence of cancer in 2020 [1] will make cancer the predominant health problem in the developed world. Although gastric cancer is not now very common in the USA and Western North Europe, worldwide it remains the second cause of mortality among malignancies with high incidence rates in several countries including Japan and Korea.

Over the last few years, the rate of laparoscopic gastrectomy for early gastric cancer is rapidly growing in Korea and Japan. Most data published on laparoscopic gastrectomy come from a few highly specialized institutions. Large-scale retrospective studies and a randomized trial on quality of life (QOL) have most recently published [2,3]. With an increasing pressure by patients and their physicians because of improved QOL, it is expected a wider clinical use of closed laparoscopic or robotic surgery. What are the risks of this approach which such as open surgery requires a D2 lymphadenectomy? Can the indications of laparoscopic gastrectomy be exceeded including also advanced stage II and III disease? Do we need randomized trials? The benefit of closed gastrectomy as compared to open gastrectomy in QOL outcomes is limited to the early 3 months postoperative period or it has also long-term favorable effects? This commentary addresses all these issues in the light of most recent published data.