Predicting prognosis of gastric cancer: limitations of metastatic lymph nodes number and promise of genomics.

摘要

Currently, decision-making on adjuvant chemotherapy in gastric cancer is based on the International Union against cancer (UICC) tumor-node-metastasis (TNM) staging system. Evidence from large randomized controlled trials supports use of adjuvant chemotherapy or chemoradio-therapy for patients with stage II or III gastric cancer or stage IB-IV for resectable cancer in the gastroesophageal junction.~1-4 For patients with stage I disease prognosis is very good and no adjuvant chemotherapy is recommended.~5,6 Although there is universal agreement that adjuvant treatment improves survival, several question have to be answered. Whether limited D1 or extended D2 lymphadenectomy should be performed before or after chemotherapy with or without radiotherapy has been controversial.