Surgical intervention remains the primary method of treating gastric cancer. Whenever possible, abdominal exploration surgery should be pursued if the patient’s overall condition allows. Depending on the condition of the gastric cancer, curative resection surgery or palliative resection surgery can be performed to cure the disease or prolong life and improve quality of life.
In China, the 5-year survival rate of gastric cancer patients after curative surgery was only 30.9% in 1976, which increased to 39.4% by 1986. Some hospitals even achieved rates exceeding 50%. The improvement can be attributed to the following factors:
- A lower proportion of early-stage gastric cancer cases.
- Insufficient radical cure in the initial treatment. Due to inadequate radical resection and lymph node dissection during the initial treatment, postoperative recurrence and treatment failure occurred.
Therefore, emphasizing standardized treatment is essential. For some early-stage gastric cancers, which rarely or never have lymph node metastasis, endoscopic mucosal resection or laparoscopic local resection can be performed for curative purposes, achieving favorable results. For advanced-stage gastric cancer, in order to increase the surgical resection rate, some hospitals attempt preoperative or intraoperative radiation therapy to improve the resection rate and postoperative survival. Some hospitals also use chemotherapy before or during surgery to reduce the activity of cancer cells and prevent their spread and metastasis. For patients with lymph node metastasis, postoperative adjuvant chemotherapy can yield good results.
Due to local infiltration and distant metastasis of gastric cancer, the opportunity for curative surgery is lost, and only the primary lesion or partial metastatic lesions can be removed, which is known as palliative resection surgery. This surgery can effectively relieve obstruction, control bleeding, alleviate pain, prevent acute perforation, reduce toxic symptoms, improve quality of life, and prolong survival. The 3-year and 5-year survival rates after surgery are 13.2% and 7.1%, respectively.
In summary, based on the specific condition of the patient and the stage of gastric cancer, doctors will choose appropriate treatment methods for treatment and rehabilitation. During the treatment process, patients also need to actively participate in rehabilitation training and adopt a proper diet to improve quality of life and promote the recovery process.