Ten Thousand Consecutive Gastrectomies for Gastric Cancer: Perspectives of a Master Surgeon

Abstract

As radical gastrectomy with lymph node dissection is currently the best strategy to curegastriccancer, the role of thesurgeonremains quite important in conquering it. Dr. Sung Hoon Noh, asurgeonand surgical oncologist specializing ingastriccancer, has treatedgastriccancerfor 30 years and has conducted over 10000 cases of gastrectomy forgastriccancer. He first adapted an electrocautery device intogastriccancersurgery and has led standardization of surgical procedures, including spleen preserving gastrectomy. His procedures based on patient-oriented insights have become the basis of the concept of enhanced recovery after surgery. He has also contributed to improving patient's survival through adoption of a multidisciplinary approach: he proved the benefit of adjuvant chemotherapy after radical D2 gastrectomy for stage II/IIIgastriccancerin clinical trials, updating treatment guidelines throughout the world. Dr. Noh also opened the era of precision medicine for treatinggastriccancer, as he developed and validated a mRNA expression based algorithm to predict prognosis and response to chemotherapy. This article reviews his contribution and long history of service in the field ofgastriccancer. Theperspectivesof thismastersurgeon, based on his profound experience and insights, will outline directions for integrative multidisciplinary health care and how can surgeons prepare for the future.