Prognosis of gastric cancer in the West is poor with an overall 5-year survival rate of only 23% in the U.S.A. [1]. Although high survival rates are reported with adequate local therapy (surgery ) in early-stages gastric adenocarcinoma [2,3] or lymphoma [4], most patients in the West have a late diagnosis in advanced tumor stages with poor outcomes. Despite adequate locoregional tumor control with standardized, Japanese-type D2/D3 lymphadenectomy [2,5-8] or limited D1 surgery plus chemoradiation [9,10] and modest efficacy of adjuvant chemotherapy [11], recurrence and survival rates are disappointing [1].
