Current
best practices and rationalistic perspectives in causation-based
prevention, early detection and multidisciplinary treatment
of breast and gastric cancer
|
SPECIAL ARTICLE |
||
Proof-of-Concept
Changes Treatment Guidelines for Gastric Cancer Dimitrios H. Roukos, MD |
||
Abstract |
||
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? |
||
|
