Despite
years of research, the prognosis of Western patients with gastric
cancer, as opposed to that in Japan, remains poor. Limited, D1
node dissection is currently the routine clinical practice in
the USA and Europe whereas the impact of extensive, D2 dissection
–standard-of-care in Japan- and perioperative adjuvant treatment
are still remain debated.. |
Considering
current evidence available about:
• role of surgeon-volume factor
• safety of D2 dissection
• hypothesis-driven concept for a nodal stage (N2)-specific
survival benefit by D2 dissection most recently confirmed by the
Dutch randomized controlled trial (RCT)
• effectiveness and toxicity of perioperative (neoadjuvant,
intraperitoneal, postoperative) adjuvant treatment |