Impact of treatment guidelines and pivotal clinical trial results on a surgeon’s decision regarding treatment for gastric cancer: a retrospective cohort study using the National Clinical Database

The present study evaluated the impact of clinical guidelines for gastric cancer surgery on surgeons' choice of procedure in real-world practice. We focused on the 2014 guideline revision recommending laparoscopic surgery and the evidence concerning splenectomy for prophylactic lymphadenectomy reported in 2015 using the National Clinical Database, which is the most comprehensive database in Japan. We investigated the monthly percentages of laparoscopic distal gastrectomies performed for stage I gastric cancer (LDG