Surgery for gastric cancer: the American view.

Gastric cancer has decreased significantly in incidence during the last half century in this country. Developments in surgery for gastric cancer have been slowed by the large percentage of patients presenting with advanced stages of the disease. In many ways, the combination and magnitude of these two characteristics pose a unique hurdle to progress in gastric cancer management in the United States. This review concentrates on current surgical issues, and offers a management approach that allows for continued progress in the pursuit of prolonging quality survival for patients with this disease.