Standard surgery for gastric cancer in UK

The national guidelines for gastric resection advocate radical lymphadenectomy. However, the surgical practice is highly variable and is surgeon dependent. Randomised controlled trials that have been carried out by non-specialists in low volume centres did not reflect the optimum environment to study the value of lymphadenectomy in western population. The impact of those trials has now expired. The majority of centres aim for radical approach although the definition of the extent of lymphadenectomy and the quality of performance is highly variable. Few UK centres have produced outcomes that are comparable with data from Japan. The centralization of gastric cancer surgery has undoubtedly played a major role in the adoption of radical lymphadenectomy and improving surgical outcomes.