Open AccessR0 resection in the treatment of gastric cancer: Room for improvement
Author(s) -
Alberto Biondi,
Roberto Persiani,
Ferdinando Carlo Maria Cananzi,
Marco Zoccali,
Vincenzo Vigorita,
Andrea Tufo,
Domenico D’Ugo
Publication year - 2010
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v16.i27.3358
Subject(s) - medicine , cancer , pathological , lymphatic system , lymphovascular invasion , stage (stratigraphy) , metastasis , lymph node , resection , gastric carcinoma , curative treatment , oncology , surgery , disease , pathology , paleontology , biology
Gastric carcinoma is one of the most frequent malignancies in the world and its clinical behavior especially depends on the metastatic potential of the tumor. In particular, lymphatic metastasis is one of the main predictors of tumor recurrence and survival, and current pathological staging systems reflect the concept that lymphatic spread is the most relevant prognostic factor in patients undergoing curative resection. This is compounded by the observation that two-thirds of gastric cancer in the Western world presents at an advanced stage, with lymph node metastasis at diagnosis. All current therapeutic efforts in gastric cancer are directed toward individualization of therapeutic protocols, tailoring the extent of resection and the administration of preoperative and postoperative treatment. The goals of all these strategies are to improve prognosis towards the achievement of a curative resection (R0 resection) with minimal morbidity and mortality, and better postoperative quality of life.