1 Introduction

Gastric cancer remains a major health issue globally, particularly in Asia, where the incidence remains high despite global decreases. Surgery is the primary curative option, especially when the disease is detected at an early stage. Minimally invasive surgical techniques, including laparoscopic and robotic-assisted surgeries, have significantly improved patient outcomes by reducing recovery times and surgical complications. These innovations, along with advanced diagnostic technologies such as endoscopic ultrasonography, have contributed to the more effective treatment of early-stage gastric cancer (Chen et al., 2021). Additionally, endoscopic techniques like mucosal resection have become valuable tools for treating early cancers (Koeda et al., 2011).

Surgical resection is the cornerstone of gastric cancer treatment, particularly in early-stage cases where a complete tumor removal (R0 resection) is the goal. The success of this approach largely depends on performing an adequate lymphadenectomy, which improves survival rates. Minimally invasive surgeries have demonstrated equivalent oncological outcomes compared to traditional open surgeries and offer additional benefits such as quicker recovery and fewer complications. In advanced stages, surgery alone is often insufficient, and multimodal treatments involving perioperative chemotherapy are crucial to improving patient outcomes (Newton et al., 2015).

This report provides a comprehensive review of advancements in gastric cancer resection techniques, with a focus on the integration of minimally invasive surgery in current clinical practice. It also highlights the importance of perioperative treatment in cases of advanced gastric cancer. The report offers insights into the latest developments in the field of gastric cancer surgery, emphasizing how precision medicine improves patient survival rates and quality of life.

2 Current Surgical Techniques in Gastric Cancer Resection

2.1 Open gastrectomy: indications and surgical outcomes

Open gastrectomy remains the traditional approach for treating both early and advanced gastric cancers. It is particularly indicated for tumors that are located in areas where minimally invasive techniques might be difficult to perform or when the tumor has advanced to a stage requiring extensive dissection. This approach provides a clear view of the surgical field and allows for complete removal of the tumor with adequate margins and lymph node dissection. Studies indicate that open gastrectomy results in good oncological outcomes, especially when performed in high-volume centers. However, it is associated with longer recovery times and a higher complication rate compared to minimally invasive approaches (Coburn et al., 2018).

2.2 Laparoscopic gastrectomy: advancements and benefits

Laparoscopic gastrectomy has revolutionized gastric cancer surgery, particularly for early-stage disease. This minimally invasive technique offers benefits such as reduced blood loss, shorter hospital stays, and quicker recovery times. Several studies have shown that laparoscopic gastrectomy offers comparable oncological outcomes to open gastrectomy while providing enhanced postoperative recovery and quality of life. Its feasibility for advanced cases is still being evaluated, but early data suggest that, when combined with perioperative chemotherapy, it may be an effective alternative for certain patients (Figure 1) (Straatman et al., 2015).

2.3 Robotic-assisted gastrectomy: technical innovations and clinical impact

Robotic-assisted gastrectomy represents the latest advancement in gastric cancer surgery, offering enhanced precision through improved visualization and dexterity. This technology has been particularly beneficial in performing complex procedures, such as total gastrectomies or extensive lymphadenectomies, which are more challenging in traditional laparoscopic surgeries. Robotic surgery minimizes the limitations of laparoscopic instruments, such as restricted movement, and provides better access to hard-to-reach areas. The clinical outcomes, including reduced postoperative pain and quicker recovery times, are promising, although the high cost and longer operative times remain challenges (Caruso et al., 2016).

2.4 Comparison of different techniques: efficacy, safety, and recovery

When comparing open, laparoscopic, and robotic-assisted gastrectomies, each technique has distinct advantages and drawbacks. Open gastrectomy provides the most comprehensive surgical access, which is crucial for advanced-stage tumors but results in higher morbidity. Laparoscopic gastrectomy offers a less invasive alternative with comparable oncologic outcomes and better postoperative recovery, particularly in early-stage cancers. Robotic-assisted surgery, while the most advanced, is still limited by cost and accessibility, though it shows potential for being the gold standard in complex cases due to its precision and reduced postoperative complications. Studies have shown that both laparoscopic and robotic surgeries lead to shorter hospital stays and quicker recovery, while open surgery remains essential for more complicated, late-stage cases (Rosa et al., 2022).

3 Advances in Minimally Invasive Gastric Cancer Surgery

3.1 Single-incision laparoscopic surgery (SILS) and its application in gastric cancer

Single-incision laparoscopic surgery (SILS) is a relatively new development in minimally invasive surgery that allows surgeons to perform gastric resections through a single small incision, typically at the umbilicus (Wang, 2024a). This technique offers cosmetic benefits and a potentially quicker recovery compared to conventional multi-port laparoscopic surgery. Studies have shown that SILS is a feasible and safe option for early gastric cancer, offering similar oncologic outcomes as conventional laparoscopic surgery. However, its use in more advanced stages of gastric cancer is still under investigation, and large-scale studies are required to confirm its long-term efficacy (Son and Kim, 2014).

3.2 Endoscopic Submucosal Dissection (ESD): Indications and Effectiveness

Endoscopic submucosal dissection (ESD) is a minimally invasive procedure used primarily for the treatment of early gastric cancer that is confined to the mucosa or submucosa and has no lymph node metastasis. ESD allows for en bloc resection of tumors, ensuring clear margins and reducing the risk of recurrence. It is particularly useful for small, localized tumors. Studies have demonstrated that ESD offers excellent long-term survival rates, comparable to surgical options, with fewer complications and a quicker recovery period. Its use is expanding globally, particularly in Japan and South Korea, where early detection programs are more prevalent (Ryu, 2015).

3.3 Hybrid techniques combining endoscopic and laparoscopic approaches

Hybrid surgical techniques that combine both endoscopic and laparoscopic methods have emerged as promising options for treating gastric cancer, particularly in cases where traditional surgery may be overly invasive. These techniques involve using endoscopy to visualize and dissect tumors internally while laparoscopic tools assist in resecting and removing the affected tissue. This approach offers the precision of endoscopic techniques with the broader surgical access of laparoscopy. Hybrid procedures are typically used for early-stage cancers and have shown favorable outcomes, including reduced operative times and fewer complications (Su and Bu, 2023).

3.4 Patient selection criteria for minimally invasive techniques

The success of minimally invasive techniques in gastric cancer depends heavily on patient selection. Ideal candidates for these procedures include those with early-stage tumors that are localized without lymph node involvement or metastasis (Wang, 2024b). Laparoscopic and endoscopic approaches are best suited for patients with early gastric cancer or those who have favorable tumor characteristics, such as size and depth of invasion. Advanced techniques like robotic surgery may be used for more complex cases, but careful assessment is required to determine the best course of action. Factors such as tumor location, patient comorbidities, and surgeon expertise also play a crucial role in determining eligibility for minimally invasive surgery (Lee and Kim, 2022).

4 Challenges and Limitations of Current Surgical Techniques

4.1 Technical challenges in robotic and laparoscopic surgeries

Robotic and laparoscopic surgeries for gastric cancer, while less invasive and associated with quicker recovery times, come with several technical challenges. Laparoscopic surgeries, particularly for advanced gastric cancer, often face limitations in performing extended lymphadenectomy due to limited visualization and maneuverability. Robotic surgeries, though offering better precision and control, require longer operation times and come with higher costs. Additionally, robotic systems are not widely available, limiting their accessibility to certain regions and hospitals (Parisi et al., 2015). Surgeons also face challenges in performing intracorporeal anastomoses, which require high levels of technical skill (Lee et al., 2015).

4.2 Complications and postoperative morbidity: case studies

Despite the benefits of minimally invasive techniques, complications such as anastomotic leaks, bleeding, and infections can occur. Studies have shown that while laparoscopic surgeries lead to fewer immediate postoperative complications compared to open surgeries, there are cases where morbidity rates remain similar, particularly in advanced-stage cancers. Robotic surgeries, though reducing blood loss and pain, have not consistently demonstrated lower complication rates compared to laparoscopic procedures in real-world applications (Greenleaf et al., 2017).

4.3 Limitations of minimally invasive surgery in advanced gastric cancer

The application of minimally invasive surgery (MIS) in advanced gastric cancer remains controversial. While feasible in early gastric cancer, MIS for advanced stages poses challenges in terms of ensuring adequate lymph node dissection and achieving oncologic safety. Extended lymphadenectomy, which is crucial for advanced cancers, is technically more difficult using MIS due to limited access and visualization. Moreover, there is insufficient evidence to confirm that MIS offers long-term survival benefits in advanced-stage cases, as highlighted by ongoing clinical trials (Desiderio et al., 2015).

4.4 Addressing skill gaps in surgeons: training and certification

A key limitation of adopting advanced surgical techniques like robotic and laparoscopic gastrectomies is the skill gap among surgeons. MIS requires specialized training, including learning to operate advanced robotic systems, which are not universally available. Certification programs and hands-on workshops are essential for equipping surgeons with the necessary skills to perform these complex procedures safely and effectively. However, the learning curve for these techniques remains steep, and it is crucial to develop more standardized training and certification pathways to ensure competency across regions (Cassidy et al., 2017).

5 Role of Multidisciplinary Teams in Gastric Cancer Surgery

5.1 Importance of preoperative assessment and collaboration

Preoperative assessment plays a critical role in optimizing outcomes for gastric cancer surgery, and the involvement of multidisciplinary teams (MDTs) is vital in this process. MDTs enable comprehensive evaluations that include surgeons, oncologists, radiologists, and other specialists, ensuring that all aspects of the patient’s condition are considered. Through coordinated preoperative discussions, the team can assess the tumor stage, evaluate the patient's overall health, and decide the best surgical approach or the need for neoadjuvant treatments such as chemotherapy or radiotherapy. Studies have shown that MDTs help improve diagnostic accuracy and treatment planning, reducing the likelihood of unnecessary or delayed interventions (Boniface et al., 2016).

5.2 Integration of surgeons, oncologists, and radiologists for optimal outcomes

The integration of multiple specialties in the treatment of gastric cancer is essential to achieving optimal patient outcomes. Collaboration among surgeons, medical oncologists, and radiologists allows for better decision-making, particularly when considering complex cases. By combining expertise, these teams ensure that patients receive personalized treatment plans tailored to their specific conditions. Evidence shows that multidisciplinary teams are associated with better survival outcomes, especially when decisions are made collectively regarding the extent of surgery, the use of adjuvant therapies, and the timing of interventions (Xiang et al., 2022).

5.3 Case studies highlighting the success of multidisciplinary approaches

Several case studies have demonstrated the effectiveness of MDTs in managing complex gastric cancer cases. For example, a retrospective study at Parkland Hospital (Dallas, TX) showed that the implementation of an MDT reduced the time to treatment from an average of 84.1 days to 32.5 days, highlighting the efficiency of parallel evaluation and decision-making across specialties. The study also found a significant reduction in unnecessary tests and an increase in the use of diagnostic laparoscopy, demonstrating how streamlined care pathways can enhance both the speed and quality of treatment (Ju et al., 2020).

6 Postoperative Care and Long-Term Management

6.1 Best practices for postoperative recovery and rehabilitation

Postoperative care in gastric cancer surgery is crucial for optimizing recovery and minimizing complications. Best practices include early mobilization, respiratory therapy, and pain management to prevent common postoperative issues such as pneumonia and deep vein thrombosis. Nutritional support is also vital, as patients often face challenges with digestion and malnutrition after gastrectomy. Minimally invasive techniques, such as laparoscopic surgeries, often result in faster recovery and fewer complications, especially for elderly patients who are at higher risk for postoperative issues (Kawaguchi et al., 2021). Rehabilitation programs, including physical therapy and dietary counseling, should be initiated early to aid in faster recovery and better quality of life post-surgery (Figure 2) (Hashimoto et al., 2019).

6.2 Monitoring for recurrence and managing complications

Surveillance for cancer recurrence is a key aspect of long-term management after gastric cancer resection. Regular follow-ups with imaging (CT scans, endoscopy) and tumor marker assessments (e.g., CEA, CA 19-9) are recommended. Postoperative complications, such as anastomotic leaks, strictures, and malabsorption, require prompt management to avoid long-term morbidity. Studies indicate that postoperative infections and complications can negatively impact overall survival, highlighting the importance of closely monitoring patients for early signs of complications (Figure 3) (Li et al., 2019).

6.3 Nutritional support and quality of life after gastric surgery

Nutritional management is a critical component of long-term care after gastrectomy. Patients often experience weight loss, malnutrition, and deficiencies in vitamins such as B12, iron, and calcium due to reduced gastric capacity and altered absorption. Proper nutritional support, including high-calorie diets and supplements, is essential to maintain a healthy weight and improve overall physical function. Long-term survivors of gastric cancer often report reduced quality of life due to digestive symptoms like dumping syndrome, nausea, and reflux. Ensuring nutritional adequacy and addressing psychological impacts related to altered body image and lifestyle changes are important factors for maintaining a good quality of life (Yu et al., 2016).

7 Future Directions in Gastric Cancer Surgery

7.1 Development of next-generation robotic systems

The next generation of robotic systems aims to overcome the limitations of current robotic surgery by enhancing precision, flexibility, and accessibility. These advancements include improved haptic feedback, which allows surgeons to feel the tissue they are manipulating, and enhanced 3D imaging for more precise anatomical visualization. Robotic systems such as the da Vinci platform are being further developed to shorten the learning curve for complex procedures like total gastrectomies, allowing for more consistent and safer surgeries, especially for lymph node dissection (Terashima et al., 2015). There is also growing interest in patient-specific 3D-printed robotic systems, which could tailor surgical tools to each individual patient, optimizing surgical outcomes.

7.2 Role of artificial intelligence in precision surgery

Artificial intelligence (AI) is becoming increasingly integrated into surgical procedures, with applications that include decision support, real-time imaging analysis, and personalized surgical planning. AI can process vast amounts of genomic and clinical data to assist surgeons in determining the best surgical approach, identifying tumor boundaries, and predicting potential complications. AI-guided systems are also being developed to assist with surgical navigation and enhance precision, particularly in identifying small lesions or critical anatomical structures during surgery (Jin et al., 2020). The combination of AI and nanotechnology is also being explored for the development of more precise cancer treatments that integrate surgical and therapeutic interventions (Adir et al., 2019).

7.3 Integration of genomic and molecular data in surgical decision-making

The field of precision medicine is revolutionizing gastric cancer surgery by incorporating genomic and molecular data to tailor treatments to individual patients. Genomic profiling allows for the identification of specific mutations or biomarkers that can guide decisions regarding the extent of resection and the need for adjuvant therapies (Mihmanlı et al., 2016). Molecular diagnostics also aid in staging and assessing the risk of metastasis, allowing surgeons to plan more targeted and personalized interventions (Wang et al., 2021). In the future, molecular diagnostics could enable real-time adjustments during surgery, improving outcomes and reducing recurrence rates.

7.4 Potential of 3D printing and custom implants in gastric surgery

3D printing is showing great promise in gastric cancer surgery by enabling the creation of patient-specific anatomical models for preoperative planning and the development of custom implants. Surgeons can use 3D-printed models to simulate complex procedures, improving surgical precision and reducing operative times. The technology also holds potential for creating custom gastric or esophageal implants that can replace resected tissue, particularly in complex reconstructions following extensive cancer resections (Jovic et al., 2020). Additionally, bioprinting techniques are being explored to develop tissue scaffolds that could eventually lead to regenerative treatments for damaged gastric tissues.

8 Concluding Remarks

Over the past decade, significant advancements in gastric cancer resection techniques have been made, particularly in minimally invasive approaches like laparoscopic and robotic-assisted surgeries. These techniques have shown to improve patient recovery times, reduce postoperative complications, and offer comparable oncologic outcomes to traditional open surgeries. Innovations such as endoscopic submucosal dissection (ESD) have provided alternatives to surgery for early-stage gastric cancer, allowing for effective en bloc resections of lesions without extensive lymphadenectomy. Furthermore, the introduction of robotic systems like the da Vinci platform has enabled greater precision and improved lymph node dissection in advanced cases.

The adoption of minimally invasive techniques in clinical practice is transforming the management of gastric cancer. The use of laparoscopic and robotic surgeries, particularly in early-stage cancers, has led to shorter hospital stays and fewer postoperative complications, significantly improving patients' quality of life. These advancements, coupled with multimodal approaches that include neoadjuvant and adjuvant therapies, are contributing to improved survival rates, especially in locally advanced gastric cancers. However, the need for specialized training and the high costs associated with robotic systems present challenges in widespread adoption.

Future research should focus on optimizing patient selection criteria for minimally invasive surgeries, particularly in advanced gastric cancer cases. There is a need for large-scale clinical trials to evaluate the long-term oncologic outcomes of robotic-assisted surgeries and to determine the optimal extent of lymphadenectomy in minimally invasive settings. Additionally, the integration of artificial intelligence (AI) in surgical planning and navigation holds significant potential for precision surgery. AI could assist in real-time decision-making, improving surgical accuracy and reducing intraoperative complications. The development of 3D-printed surgical tools and custom implants, tailored to individual patients' anatomy, represents another exciting area of innovation that could further enhance outcomes in gastric cancer surgery.

Acknowledgments

The publisher sincerely thanks the anonymous peer reviewers for their thorough evaluation of this manuscript.

Conflict of Interest Disclosure

The author affirms that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

References

Adir O., Poley M., Chen G., Froim S., Krinsky N., Shklover J., Shainsky‐Roitman J., Lammers T., and Schroeder, A., 2019, Integrating artificial intelligence and nanotechnology for precision cancer medicine, Advanced Materials, 32(13): e1901989.

https://doi.org/10.1002/adma.201901989

PMID: 31286573 PMCID: PMC7124889

Boniface M.M., Wani S., Schefter T., Koo P., Meguid C., Leong S., Kaplan J., Wingrove L.J., and McCarter M., 2016, Multidisciplinary management for esophageal and gastric cancer, Cancer Management and Research, 8: 39-44.

https://doi.org/10.2147/CMAR.S101169

Caruso S., Patriti A., Roviello F., de Franco L., Franceschini F., Coratti A., and Ceccarelli G., 2016, Laparoscopic and robot-assisted gastrectomy for gastric cancer: current considerations, World Journal of Gastroenterology, 22(25): 5694-5717.

https://doi.org/10.3748/wjg.v22.i25.5694

Cassidy M., Gholami S., and Strong V., 2017, Minimally invasive surgery: The emerging role in gastric cancer, Surgical Oncology Clinics of North America, 26(2): 193-212.

https://doi.org/10.1016/j.soc.2016.10.001

Chen J., Bu Z., and Ji J., 2021, Surgical treatment of gastric cancer: current status and future directions, Chinese Journal of Cancer Research, 33: 159-167.

https://doi.org/10.21147/j.issn.1000-9604.2021.02.04

PMID: 34158736 PMCID: PMC8181878

Coburn N., Cosby R., Klein L., Knight G., Malthaner R., Mamazza J., Mercer C., and Ringash J., 2018, Staging and surgical approaches in gastric cancer: A systematic review, Cancer Treatment Reviews, 63: 104-115.

https://doi.org/10.1016/j.ctrv.2017.12.006

PMID: 29275224

Desiderio J., Jiang Z.W., Nguyen N., Zhang S., Reim D., Alımoglu O., and Yu P., 2015, Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review, BMJ Open, 5: e008198.

https://doi.org/10.1136/bmjopen-2015-008198

PMID: 26482769 PMCID: PMC4611863

Greenleaf E.K., Sun S.X., Hollenbeak C., and Wong J., 2017, Minimally invasive surgery for gastric cancer: the american experience, Gastric Cancer, 20: 368-378.

https://doi.org/10.1007/s10120-016-0605-5

Hashimoto T., Kurokawa Y., Mikami J., Takahashi T., Miyazaki Y., Tanaka K., Makino T., Yamasaki M., Motoori M., Kimura Y., Nakajima K., Mori M., and Doki Y., 2019, Postoperative long-term outcomes in elderly patients with gastric cancer and risk factors for death from other diseases, World Journal of Surgery, 43: 2885-2893.

https://doi.org/10.1007/s00268-019-05109-5

PMID: 31388706

Jin P., Ji X., Kang W., Li Y., Liu H., Ma F., Ma S., Hu H., Li W., and Tian Y., 2020, Artificial intelligence in gastric cancer: A systematic review, Journal of Cancer Research and Clinical Oncology, 146(9): 2339-2350.

https://doi.org/10.1007/s00432-020-03304-9

PMID: 32613386

Jovic T., Combellack E., Jessop Z., and Whitaker I., 2020, 3D bioprinting and the future of surgery, Frontiers in Surgery, 7: 609836.

https://doi.org/10.3389/fsurg.2020.609836

PMID: 33330613 PMCID: PMC7728666

Ju M., Wang S.C., Syed S., Agrawal D., and Porembka M., 2020, Multidisciplinary teams improve gastric cancer treatment efficiency at a large safety net hospital, Annals of Surgical Oncology, 27: 645-650.

https://doi.org/10.1245/s10434-019-08037-9

PMID: 31677108

Kawaguchi Y., Akaike H., Shoda K., Furuya S., Hosomura N., Amemiya H., Kawaida H., Kono H., and Ichikawa D., 2021, Is surgery the best treatment for elderly gastric cancer patients? World Journal of Gastrointestinal Surgery, 13: 1351-1360.

https://doi.org/10.4240/wjgs.v13.i11.1351

PMID: 34950425 PMCID: PMC8649569

Koeda K., Nishizuka S., and Wakabayashi G., 2011, Minimally invasive surgery for gastric cancer: The future standard of care, World Journal of Surgery, 35: 1469-1477.

https://doi.org/10.1007/s00268-011-1051-5

Lee J.H., Kim Y., Woo Y., Obama K., Noh S., and Hyung W., 2015, Robotic distal subtotal gastrectomy with D2 lymphadenectomy for gastric cancer patients with high body mass index: Comparison with conventional laparoscopic distal subtotal gastrectomy with D2 lymphadenectomy, Surgical Endoscopy, 29: 3251-3260.

https://doi.org/10.1007/s00464-015-4069-1

Lee S., and Kim H.H., 2022, Minimally invasive surgery in advanced gastric cancer, Annals of Gastroenterological Surgery, 6: 336-343.

https://doi.org/10.1002/ags3.12559

PMID: 35634188

Li J., Zhang Y., Hu D., Gong T., Xu R., and Gao J., 2019, Impact of postoperative complications on long-term outcomes of patients following surgery for gastric cancer: A systematic review and meta-analysis, Asian Journal of Surgery, 43(7): 719-729.

https://doi.org/10.1016/j.asjsur.2019.10.007

Mihmanlı M., İlhan E., Idiz U.O., Alemdar A., and Demir U., 2016, Recent developments and innovations in gastric cancer, World Journal of Gastroenterology, 22(17): 4307-4320.

https://doi.org/10.3748/wjg.v22.i17.4307

PMID: 27158199 PMCID: PMC4853688

Newton A.D., Datta J., Loaiza-Bonilla A., Karakousis G., and Roses R., 2015, Neoadjuvant therapy for gastric cancer: Current evidence and future directions, Journal of Gastrointestinal Oncology, 6(5): 534-543.

https://doi.org/10.3978/j.issn.2078-6891.2015.047

PMID: 26487948 PMCID: PMC4570921

Parisi A., Nguyen N., Reim D., Zhang S., Jiang Z., Brower S., and Azagra J., 2015, Current status of minimally invasive surgery for gastric cancer: A literature review to highlight studies limits, International Journal of Surgery, 17: 34-40.

https://doi.org/10.1016/j.ijsu.2015.02.021

PMID: 25758348

Rosa F., Schena C., Laterza V., Quero G., Fiorillo C., Strippoli A., Pozzo C., Papa V., and Alfieri S., 2022, The role of surgery in the management of gastric cancer: State of the art, Cancers, 14.

https://doi.org/10.3390/cancers14225542

PMID: 36428634 PMCID: PMC9688256

Ryu K., 2015, Recent advances in minimally invasive surgery for gastric cancer, Journal of The Korean Medical Association, 58(3): 197-200.

https://doi.org/10.5124/JKMA.2015.58.3.197

Son S.Y., and Kim H.H., 2014, Minimally invasive surgery in gastric cancer, World Journal of Gastroenterology, 20(39): 14132-14141.

https://doi.org/10.3748/wjg.v20.i39.14132

PMID: 25339802 PMCID: PMC4202344

Straatman J., van der Wielen N., Cuesta M., Gisbertz S., Hartemink K., Alonso Poza A., Weitz J., Mateo Vallejo F., Ahktar K., Diez del Val I., Roig García J., and van der Peet D.L., 2015, Surgical techniques, open versus minimally invasive gastrectomy after chemotherapy (STOMACH trial): Study protocol for a randomized controlled trial, Trials, 16.

https://doi.org/10.1186/s13063-015-0638-9

PMID: 25873249 PMCID: PMC4397942

Su H., and Bu Z., 2023, Research progress of minimally invasive surgery for gastric cancer, Chinese Journal of Cancer Research, 35(4): 343-353.

https://doi.org/10.21147/j.issn.1000-9604.2023.04.02

PMID: 37691896 PMCID: PMC10485916

Terashima M., Tokunaga M., Tanizawa Y., Bando E., Kawamura T., Miki Y., Makuuchi R., Honda S., Tatsubayashi T., Takagi W., Omori H., and Hirata F., 2015, Robotic surgery for gastric cancer, Gastric Cancer, 18: 449-457.

https://doi.org/10.1007/s10120-015-0501-4

PMID: 25899666

Wang W., 2024a, The application and challenges of emerging technologies in early diagnosis and screening of gastric cancer: from molecular markers to imaging advances, Cancer Genetics and Epigenetics, 12(1): 37-46

https://doi.org/10.5376/cge.2024.12.0005

Wang T., 2024b, The application prospects of immunomodulators in cancer treatment, Cancer Genetics and Epigenetics, 12(1): 1-7.

https://doi.org/10.5376/cge.2024.12.0001

Wang Y., Zhang L., Yang Y., Lu S., and Chen H., 2021, Progress of gastric cancer surgery in the era of precision medicine, International Journal of Biological Sciences, 17: 1041-1049.

https://doi.org/10.7150/ijbs.56735

PMID: 33867827 PMCID: PMC8040314

Xiang Y., Deng C.C., Liu H., Kuo Z., Zhang C.H., and He Y.L., 2022, The prognostic effect of multidisciplinary team intervention in patients with advanced gastric cancer, Current Oncology, 29: 1201-1212.

https://doi.org/10.3390/curroncol29020102

PMID: 35200601 PMCID: PMC8871247

Yu W., Park K., Chung H., Kwon O., and Lee S.S., 2016, Chronological changes of quality of life in long-term survivors after gastrectomy for gastric cancer, Cancer Research and Treatment, 48: 1030-1036.

https://doi.org/10.4143/crt.2015.398

PMID: 27004956 PMCID: PMC4946352