Gastric cancer surgery in South Korea: Past, present, and future

Abstract

Gastric cancer remains a significant global health concern and its surgical management approaches have undergone significant changes in South Korea and worldwide. Subtotal or total gastrectomy with D2 lymph node dissection is well established as a standard surgical procedure for gastric cancer. With the active implementation of cancer screening in South Korea, the proportion of early gastric cancer cases has significantly increased over the past few decades, leading to a steady increase in the survival rate among patients. Furthermore, recent advances in surgical instruments and techniques have made minimally invasive surgery increasingly prevalent, not only for early but also for advanced gastric cancer. We aim to provide a comprehensive overview of the evolution and current status of gastric cancer surgery in South Korea.

Keywords: Function-preserving surgery; gastric cancer; minimally invasive surgery; surgery.

Figure 1

Epidemiology of gastric cancer in South Korea. (A) Proportion of EGC and AGC over time; (B) Total incidence and mortality rates of gastric cancer, 1999−2019. EGC, early gastric cancer; AGC, advanced gastric cancer.

Figure 2

Changes in operative approach and type over time. (A) Proportion of operative approaches over time; (B) Proportion of operative types. DG, distal gastrectomy; TG, total gastrectomy; PG, proximal gastrectomy; PPG, pylorus-preserving gastrectomy.