Lymphadenectomy in gastric cancer treatment requires tailored approaches for different patient scenarios.

• Individualized decisions for lymphadenectomy are crucial based on patient factors and radiographic nodal involvement, especially in conversion and cytoreductive surgeries.
• Optimal lymphadenectomy extent for gastroesophageal junction cancers is driven by tumor classification and invasion length.

Surgeons need to consider unique drainage patterns in remnant gastric cancer for proper lymph node selection and staging accuracy.

• Lymphadenectomy is critical for MSI-high tumors despite their favorable prognosis and is not needed for most gastrointestinal stromal tumors unless specific conditions apply.

Surgeons should note that achieving the Textbook Outcome in gastric cancer surgery significantly enhances patient survival and reduces hospital stays.

• 74.7% of 5806 patients achieved the Textbook Outcome, with 87.6% 5-year survival for those who did.
• Success rates varied by stage: 77.9% for stage I and 68.8% for stages II-III.

Older patients had lower achievement rates; 82.3% for those under 40 vs. 67.5% for those over 80.

Consider factors like early lesions, female sex, and minimally invasive techniques to optimize outcomes.

Surgery for Barrett’s esophagus shows a significant regression rate, particularly in shorter segments, influencing patient management.

• Histologic regression occurred in 53.4% of patients overall, with 68.9% in ultrashort and 51.2% in short segments, but 0% in long-segment Barrett’s (p<0.001).
• Key predictors of regression included an anatomically intact repair (64.2% vs. 38.8% for disrupted, p<0.001) and the absence of severe esophagitis (OR 3.31, p=0.002).

Understanding these predictors can guide surveillance strategies and surgical decision-making for Barrett’s patients.

• Patients with no regression often presented with larger hiatal hernias and more severe reflux symptoms.