Is surgical treatment the first choice for gastric cancer?

Due to the improvement of gastric cancer diagnosis and treatment, the indications for surgery have been expanded compared with the past. Currently, except for patients with huge primary lesions, extensive metastasis to abdominal organs, bloody ascites and cachexia, as long as the general condition permits, even if there are supraclavicular lymph node metastases and metastatic nodules in the liver, surgical treatment should be sought to remove the primary lesion and alleviate symptoms.

There are two types of surgery: ① Radical resection. There are two types of radical resection: radical resection and extended radical resection. The former should include the primary lesion, together with 2/3 or 4/5 of the distal stomach, all the greater and lesser omentum, the first part of the duodenum and regional lymph nodes, and the locally infiltrated organs. The stomach or duodenum should be free of cancer cells and residual cancer; the latter should include the above contents, and also include the entire stomach or the adjacent invaded transverse colon, left lobe of the liver, spleen, pancreatic body and tail, and lymph nodes beside the left cardia and splenic blood vessels. ② Palliative resection. When gastric cancer has extensive peritoneal or lymph node metastasis, and the primary tumor can be removed, and the patient can generally tolerate the operation, palliative gastrectomy can be performed. This operation can alleviate the patient's poisoning symptoms and eliminate complications such as obstruction, bleeding or perforation caused by cancer. Chemotherapy and Chinese medicine treatment after surgery can prolong the patient's survival.