In spite of its decreasing incidence in Western countries, cancer of the stomach continues to be a significant global problem and is characterized by advanced stage presentation and low cure rates. During the last two decades, there have been some major changes and much controversy regarding the type of surgical treatment for gastric cancer. While Japanese authors have consistently reported improved cure rates following their standardized radical resection of the stomach and regional lymph nodes, skepticism has continued in the Western world regarding the appropriateness of extended resections and radical lymphadenectomy.
This retrospective study from the Mayo Clinic is interesting because it evaluates the outcome of 187 standard curative resections for gastric cancer distal to the cardia in an elderly patient population. The authors have achieved an impressive overall 5-year survival rate of 48% of the patients, with acceptable mortality and morbidity rates of 4% and 27%, respectively. These results