Gastric cancer: Clinical Practice Guidelines in oncology™
Gastric cancer is rampant in several countries worldwide. Its incidence in the Western hemisphere has been declining for more than 40 years; however, the location of gastric cancer has shifted proximally in the past 15 years. The reason for this shift is unclear. Diffuse histology is also more common now than intestinal type of histology. Advances have been made in staging procedures, such as laparoscopy and endoscopic ultrasonography, and in possible functional imaging techniques. The current TNM classification requires an examination of at least 15 lymph nodes; a DO dissection is unacceptable. Patients with locoregional gastric carcinoma should also be referred to high-volume treatment centers. Combination chemotherapy and radiotherapy in the adjuvant setting for a select group of patients is the new standard in the United States. These guidelines provide a uniform systematic approach to gastric cancer in the United States. Investigation results for new chemotherapeutic agents, including antireceptor agents, vaccines, gene therapy, and antiangiogenic agents, and many future advances in the treatment of gastric carcinoma are anticipated. © Journal of the National Comprehensive Cancer Network.
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