Gastric cancer (GC) is a malignant tumor of the gastrointestinal tract associated with high mortality rates and accounting for approximately 1 million new cases diagnosed annually. Surgery, particularly radical gastrectomy, remains the primary treatment; however, there are currently no specific approaches to better distinguish malignant from healthy tissue or to differentiate between metastatic and non-metastatic lymph nodes. As a result, surgeons have to remove all lymph nodes indiscriminately, increasing intraoperative risks for patients and prolonging hospital stay. Near-infrared fluorescence imaging with indocyanine green (ICG) can provide real-time visualization of the surgical field using both conventional laparoscopy and robotic mini-invasive precision surgery platforms. However, its application shows some limits, as ICG is a non-targeted contrast agent. Several studies are now investigating the potential efficacy of fluorescent targeted agents that could selectively bind to the tumor tissue, offering a valuable tool for metastatic mapping during robotic gastrectomy. This review aims to summarize the key fluorescent agents that have been developed to recognize GC markers, as well as those targeting the tumor microenvironment (TME) and metabolic features. These agents hold great potential as valuable tools for enhancing precision surgery in robotic gastrectomy procedures improving the clinical recovery of GC patients.

Esophageal and gastric cancers remain significant global health concerns and continue to rank among the leading causes of cancer-related death. Rising life expectancy and demographic shifts have shifted the disease burden toward older adults, with an increasing proportion of patients aged 75 years and above undergoing surgical treatment. This population often presents with diminished cardiopulmonary reserve, multiple comorbidities, malnutrition, and sarcopenia, all of which heighten perioperative risk. Frailty has emerged as a key determinant of surgical outcomes, outperforming chronological age in predicting morbidity, mortality, and functional recovery. Comprehensive Geriatric Assessment and validated frailty screening tools enable personalized risk profiling and targeted prehabilitation strategies. Minimally invasive approaches—particularly robotic-assisted techniques—have shown reduced operative stress, fewer pulmonary complications, and faster recovery while preserving oncologic effectiveness. Optimal management requires a multidisciplinary, frailty-oriented model that integrates physiological optimization, nutritional support, and evidence-based surgical planning to balance curative intent with quality of life. Future studies should prioritize prospective trials that include elderly cohorts, incorporate patient-reported and functional outcomes, and develop tailored guidelines to address the complex needs of this rapidly expanding patient group.