Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1640
Peer-review started: February 17, 2019
First decision: February 26, 2019
Revised: March 9, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 14, 2019
Core tip: The surgical treatment for early gastric cancer seems to be appropriately radical, because almost all patients can be cured by gastrectomy with lymph-node dissection up to D1+. However, after D1+ gastrectomy, multiple functional symptoms are caused by the loss of the stomach. Physicians must strive to reduce post-gastrectomy symptoms and optimize quality of life. About two-thirds of early gastric cancers are node-negative and can be resected by endoscopic submucosal dissection. The extent of lymph-node dissection can be individualized, and significant gastric preservation can be achieved, with sentinel-node biopsy. The operative method itself is still in transition.