Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer
DOI: 10.2122/gbc.2004.0032


Proof-of-Concept Changes Treatment Guidelines
for Gastric Cancer

Dimitrios H. Roukos, MD

Treatment of gastric cancer has been controversial. Studies on extent of surgery have showed conflicting results and evidence from randomized controlled trials (RCTs) is insufficient to support treatment guidelines. Currently, a proof1 of the concept2 that extensive D2 node dissection results in cure a substantial proportion of N2 patients, who have no chance of cure with D1 dissection, has been demonstrated. However, D2 increases operative mortality in inexperienced hands and is not superior to D1 dissection for patients with N0 or N1 disease [Japanese anatomical nodal classification system].3 These findings partially explain the failure of RCTs available to demonstrate a significant overall survival benefit. Is the emerging evidence sufficient for recommendations on surgical treatment of gastric cancer?

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Online ISSN : 1109 - 7647
   Print ISSN : 1109 - 7655

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last update: 3 February 2004