Erschienen in:
23.10.2018 | ASO Author Reflections
ASO Author Reflections: Nodal Downstaging in Gastric Cancer
verfasst von:
Naruhiko Ikoma, MD, MS, Brian D. Badgwell, MD, MS
Erschienen in:
Annals of Surgical Oncology
|
Sonderheft 3/2018
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Excerpt
We have been experiencing a paradigm shift in gastric cancer treatment over the past decade, from surgery alone to multimodality therapy. Most notably, since the MAGIC trial demonstrated a survival benefit with perioperative therapy, the use of preoperative chemotherapy has sharply increased.
1 This shift necessitated an update in the AJCC staging system, and the new postneoadjuvant ypStage TNM grouping was introduced in the 8th edition.
2 Although this concept was novel, due to the paucity of the actual survival data of patients who underwent preoperative therapy, the ideal ypTNM grouping is unknown. As part of our programmatic investigation of this topic, we examined the survival impact of downstaging; more specifically, whether patients with clinically node-positive disease (cN+) converted to pathologically N0 (ypN0) status can achieve similar survival to patients with N0 status before preoperative therapy (cN0 and ypN0).
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