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.2003.0027


Confirming Hypothesis-driven Surgical Concept
and Comparing Potential Survival Benefit Expected by D2 Surgery and Adjuvant Treatment

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

We estimate and compare the potential impact on overall survival by a future clinical implication of D2 surgical strategy and adjuvant treatment in patients with gastric cancer in the USA and Europe.
Emphasis is given on the rational of localized nature of N2 node-positive disease and the advantage of D2 hypothesis-generating strategy to provide cure in some of these N2 patients

Find Delta Dental, MetLife Dental, Aetna Dentist, New York Dentist, San Francisco Dentist, Boston Dentist, Chicago Dentist, Los Angeles Dentist & San Diego Dentist at

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

We subscribe to the HONcode principles of the HON Foundation. Click to verify. We subscribe to the HONcode principles. Verify here.
please, read our policy about privacy and confidentiality of information and transparency of sponsorship

last update: 3 February 2004