title: Gastric cancer, version 2.2013: featured updates to the NCCN Guidelines.
abstract: The NCCN Clinical Practice Guidelines in Oncology for Gastric Cancer provide evidence- and consensus-based recommendations for a multidisciplinary approach for the management of patients with gastric cancer. For patients with resectable locoregional cancer, the guidelines recommend gastrectomy with a D1+ or a modified D2 lymph node dissection (performed by experienced surgeons in high-volume centers). Postoperative chemoradiation is the preferred option after complete gastric resection for patients with T3-T4 tumors and node-positive T1-T2 tumors. Postoperative chemotherapy is included as an option after a modified D2 lymph node dissection for this group of patients. Trastuzumab with chemotherapy is recommended as first-line therapy for patients with HER2-positive advanced or metastatic cancer, confirmed by immunohistochemistry and, if needed, by fluorescence in situ hybridization for IHC 2+.
authors.affiliation: University of Texas MD Anderson Cancer Center, USA.
authors.forename: Jaffer A
authors.initials: JA
authors.lastname: Ajani
authors.forename: David J
authors.initials: DJ
authors.lastname: Bentrem
authors.forename: Stephen
authors.initials: S
authors.lastname: Besh
authors.forename: Thomas A
authors.initials: TA
authors.lastname: D'Amico
authors.forename: Prajnan
authors.initials: P
authors.lastname: Das
authors.forename: Crystal
authors.initials: C
authors.lastname: Denlinger
authors.forename: Marwan G
authors.initials: MG
authors.lastname: Fakih
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
authors.forename: Hans
authors.initials: H
authors.lastname: Gerdes
authors.forename: Robert E
authors.initials: RE
authors.lastname: Glasgow
authors.forename: James A
authors.initials: JA
authors.lastname: Hayman
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Hofstetter
authors.forename: David H
authors.initials: DH
authors.lastname: Ilson
authors.forename: Rajesh N
authors.initials: RN
authors.lastname: Keswani
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Kleinberg
authors.forename: W Michael
authors.initials: WM
authors.lastname: Korn
authors.forename: A Craig
authors.initials: AC
authors.lastname: Lockhart
authors.forename: Kenneth
authors.initials: K
authors.lastname: Meredith
authors.forename: Mary F
authors.initials: MF
authors.lastname: Mulcahy
authors.forename: Mark B
authors.initials: MB
authors.lastname: Orringer
authors.forename: James A
authors.initials: JA
authors.lastname: Posey
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Sasson
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Scott
authors.forename: Vivian E
authors.initials: VE
authors.lastname: Strong
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Varghese
authors.forename: Graham
authors.initials: G
authors.lastname: Warren
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Washington
authors.forename: Christopher
authors.initials: C
authors.lastname: Willett
authors.forename: Cameron D
authors.initials: CD
authors.lastname: Wright
authors.forename: Nicole R
authors.initials: NR
authors.lastname: McMillian
authors.forename: Hema
authors.initials: H
authors.lastname: Sundar
mesh_terms: D003131:Combined Modality Therapy; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000628:therapy*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases