Re-evaluation and future prospect of artificial intelligence empowered of R₀ resection in gastric cancer under the precision surgical era

In the surgical oncology, the prognosis of patients is mainly dependent on the surgical radicality, with conventional R₀ resection long regarded as the cornerstone of gastric cancer. However, under the precision surgical era, technologies such as genomics, proteomics, and the application of big data and artificial intelligence (AI) have driven the transformation of gastric cancer treatment from the "experience-driven" to the "data-driven" model. This thus poses novel challenges to the conventional R₀ resection, which has prevailed for nearly five decades. The authors combine relevant clinical research to review and anticipate how the classic concept of R₀ resection can adapt to the latest research advancements in molecular pathological diagnosis, imaging analysis, AI-assisted decision-making, and perioperative comprehensive treatment under the AI empowered precision surgical era.