Current diagnosis and treatment of gastric cancer: where East meets West.

For a long time, surgery alone used to be the standard treatment for curable advanced gastric cancer. However, times have changed. Although different schedules and opinions exist between continents and countries, (neo)adjuvant treatment with chemotherapy and/or radiotherapy have been shown to improve survival outcome and are now also considered as standard. The optimal regimens are continuously under investigation as well as tailoring of treatment. Another expression of tailoring treatment is found within unraveling molecular mechanisms by pathologists and accurate preoperative staging. Furthermore, the extent of surgery is becoming more and more individualized by the use of sentinel node techniques, laparoscopic surgery, and the extent of lymph node dissection. In order to prepare the tailored treatment, preoperative staging is of great importance. Fortunately, diagnostic tools are improving continuously and the latest version of the UICC/AJCC TNM staging system for gastric cancer improves the T designations and the prognostic stratification of the N status, and has added clearer definitions for M1 disease. Nevertheless, the treatment between Eastern and Western countries differs. In this thematic issue of Digestive Surgery, we invited experts in the field of gastric cancer from the East and the West to give their evidence-based view as well as their expert opinion on topics that are still under discussion. We are very pleased that the contributing authors have provided us with excellent papers dealing with the issues that we think are ‘hot’ in the treatment of gastric cancer.