evidence provides a latest Japanese randomized controlled trial
(RCT) indicating that if patients with serosa-negative cancer,
even at presence of lymph nodes metastases, treated appropriately
with a complete and effective D2 node dissection, they have a
very high probability of cure.
Given the moderate prognosis of the patients with this tumor-specific
tumor stage in the West, could a Japanese-style treatment approach
improve the clinical outcomes of these patients in the USA and
Europe? How feasible is this treatment strategy and what are the
limitations for a wide clinical use in the West? Research focus
on innovative-agents development or surgeon’s education
on appropriate D2 dissection is the most effective way of western
public-health care towards improvement of the outcomes of patients
with early-stage gastric cancer?