| [ Summary ] |
It has been accepted that treatment for gastric cancer should be evaluated not only from the viewpoints of survival rates or response rates, but also by reviewing the quality of life (QOL), during or after treatment. Endoscopic mucosal resection and local resection of the gastric wall, through laparotomy or laparoscopic surgery, can provide the best QOL. Proximal gastrectomy, pylorus preserving gastrectomy, and autonomic nerve preserving lymphadenectomy may produce a better QOL, compared with standard gastrectomy with D2 lymphadenectomy. Because these conservative operations allow less extensive lymphadenectomy, more reliable tools to detect metastatic lymph nodes are needed. To achieve a better QOL after radical gastrectomy, with standard lymphadenectomy, various reconstructing procedures have been developed, such as reconstruction using the jejunal pouch. When patients who underwent Roux-Y reconstruction using the jejunal pouch after total gastrectomy were compared with those who underwent the rho-type Roux-Y reconstruction without the jejunal pouch, patients with the jejunal pouch had a greater food intake and a lower incidence of esophageal reflux than those without. Chemotherapy based on biochemical modulation and newly developed antiemetics decreases side effects and provides better QOL for patients with advanced gastric cancer. |