Prognostic value of preoperative staging in gastric cancer.

摘要

To date, most therapeutic efforts in gastric cancer treatment are directed toward the individualization of therapeutic protocols, tailoring the extent of surgery and integrating it with the administration of preoperative and/or postoperative treatment. The goal of such strategies is to improve prognosis through the achievement of a curative resection with minimal morbidity and mortality and better postoperative quality of life. A precise evaluation of these strategies is strictly dependent on an accurate patient selection with a reliable staging of tumor extension, lymph node involvement, and the site of distant metastases.Park et al reported a retrospective series of a 1964 gastric cancer patients who underwent curative resection. In this series, they investigated the prognostic significance of clinical UICC/AJCC and JCGC staging performed by means of CT alone. In their analysis, even if accuracy of T staging was 67.9% and accuracy of N staging was 56.9% and 57.5% for UICC/AJCC system and JCGC system, respectively, the clinical staging provided a clear-cut prognostic stratification of gastric cancer patients. Based on these results, the authors stated that clinical staging should be considered an important prognostic factor in the preoperative setting.