Advancements and challenges in treating advanced gastric cancer in the West

Table 1 Surgery trials

Trial name	Country	Status	Years	Factors	Outcome
DGCT Trial	Netherlands	Complete	1989-1993	Randomization to D1 or D2 lymphadenectomy	Increased morbidity and mortality in D2 group
					Decreased gastric cancer-related deaths and locoregional recurrences after D2 resection
IGCSG-R01	Italy	Complete	1998-2006	Randomization to D1 or D2 lymphadenectomy	No difference in morbidity and mortality
					Improved 5-yr survival in subgroup analysis of patients with positive LN after D2 resection
KLASS-011	Korea	Complete	2006-2010	Randomization to open distal gastrectomy or laparoscopic distal gastrectomy	Decreased wound complication rate in laparoscopic group with no difference in morbidity or mortality
KLASS-022	Korea	Complete	2011-2015	Randomization to open or laparoscopic gastrectomy and D2 lymph node resection	Decreased complication rates and pain scores with shorter hospital stays in laparoscopic resections
JCOG 07031	Japan	Complete	2007-2008	Prospective study with patients undergoing laparoscopic distal gastrectomy with D1 lymph node resection	Laparoscopic surgery was safe with lower than expected rates of anastomotic leaks and pancreatic fistulas

¹Clinical stage I gastric cancers only;

²Locally advanced gastric cancers only. DGCT: Dutch Gastric Cancer Group Trial; IGCSG: Italian Gastric Cancer Study Group; LN: Lymph node; KLASS: Korean Laparoscopic Surgical Society; JCOG: Japan Clinical Oncology Group.