Recent developments and innovations in gastric cancer

Table 1 Lymph node dissections according to gastrectomy type for gastric cancer

Type of gastrectomy	Type of disection	Retrieved lymph nodestations
Total	D0	Less than D1
	D1	No. 1-7
	D1+	D1 + No. 8a, 9, 11p1
	D2	D1 + No. 8a, 9, 10, 11p, 11d, 12a1
Distal subtotal	D0	Less than D1
	D1	No. 1, 3, 4sb, 4d, 5, 6, 7
	D1+	D1 + No. 8a, 9
	D2	D1 + No. 8a, 9, 11p, 12a
Pylor preserving	D0	Less than D1
	D1	No. 1, 3, 4sb, 4d, 6, 7
	D1+	D1+ No. 8a, 9
Proximal	D0	Less than D1
	D1	No. 1, 2, 3a, 4sa, 4sb, 7
	D1+	D1 + No. 8a, 9,11p2

¹If the cancer has invaded the esophagus, the No. 110 lymph node must be removed in addition to D1+ dissection, and the No. 19, 20, 110 and 111 lymph nodes must be removed in addition to D2 dissection;

²The No. 110 lymph node must be removed in addition to D1+ dissection.

Table 2 Comparison of the sixth and the seventh TNM staging systems for the pT and pN stages

Tumor localization	6th TNMstaging system	7th TNMstaging system
Lamina propria or muscularis mucosa	T1	T1a
Submukoza	T1	T1b
Muscularis propria	T2a	T2
Subseroza	T2b	T3
Serozal invasion	T3	T4a
Adjacent organ invasion	T4	T4b
1-2 lymp node metastasis	N1	N1
3-6 lymp node metastasis	N1	N2
7-15 lymp node metastasis	N2	N3a
≥ 16 lymp node metastasis	N3	N3b

Table 3 Ongoing multicentric studies of minimally invasive surgery

Country	Study	Subject
Japan	JCOG 0912 Phase III	LG vs OG
South Korea	KLASS 01 Phase III	LG vs OG
South Korea	KLASS 02-NCT01456598	LG vs OG ( for AGC )
Japan	JLSSG0901 Phase II-III	LG vs OG (for AGC)
China	CLASS 01-NCT01609309	LG vs OG (for AGC)
South Korea	KLASS 03-NCT01584336	LG vs OG (for TG)
	Phase II
South Korea	NCT01309256	LG vs RAG

AGC: Advanced gastric cancer; LG: Laparoscopic gastrectomy; OG: Open gastrectomy; RAG: Robot asisted gastrectomy; TG: Total gastrectomy.