Editorial: Advances in approaches for function-preserving gastric cancer surgery

Abstract

Gastric cancer is a common malignancy and a leading cause of cancer death globally.In the past, patients with early gastric cancer (EGC) are generally treated with standard gastrectomy. Although the survival rate in patients with EGC is more than 95%, it may cause loss of gastric functions and lower postoperative quality of life (QoL). Due to the low incidence of lymph node metastasis and the favorable prognosis in EGC, functionpreserving gastrectomy, with an adequate range of gastric resection and minimal lymphadenectomy, could improve the patient's QoL. Surgical resection is a conventional treatment for EGC. Pylorus-preserving gastrectomy and proximal gastrectomy (PG) represent the two main function-preserving surgical procedures for GC. Recently, minimally invasive approaches, such as endoscopic therapy or laparoscopic gastrectomy (including robot-assisted surgery), have been widely applied for EGC treatment. This Research Topic aims to provide a collection of reports to present novel techniques and studies on the oncological safety and effectiveness of the approaches for function-preserving gastric cancer surgery.PG is an alternative to total gastrectomy for cT1N0 EGC in the upper third of the stomach. In PG, the rate of complications, such as reflux esophagitis and anastomotic stenosis, was markedly higher compared with total gastrectomy. As a result, many scholars have explored and improved the digestive tract reconstruction methods during PG to reduce the incidence of reflux esophagitis and improve the postoperative QoL of patients. There needs to be more studies on the QoL of patients after proximal summarized the efficacy and safety data of medication in the latest prospective studies in systematic review and meta-analysis. They found that PD-1/PD-L1 inhibitors combined with neoadjuvant chemotherapy for locally advanced, resectable gastric or gastroesophageal junction adenocarcinoma were well tolerated and may confer therapeutic advantages.Collectively, the collection of research in this Research Topic provides advances in approaches for function-preserving gastric cancer surgery. There are several comparative studies in this column. In the future, the comparative data may allow clinical physicians to practice personalized and value-based care. When patients consider their best approach, they can make informed decisions about their choice of procedure based on the effectiveness and oncological safety. We are aware we did not manage to cover all aspects of the issue of function-preserving gastric cancer treatment. Also, extensive multicenter studies with sufficiently long follow-ups of large numbers of patients are needed and will help to validate these critical clinical questions. However, we believe this Research Topic has shed light on many elements and will be helpful for further research on the issue of function-preserving gastric cancer treatment in GC patients.