title: Approach to the surgical management of resectable gastric cancer.
abstract: The rates of gastric cancer, which is the third leading cause of cancer-related deaths worldwide, vary depending on geographic location. Margin-negative gastrectomy and adequate lymphadenectomy (removal of ≥15 lymph nodes) are the cornerstones of multimodal treatment for operable gastric cancer. Diagnostic laparoscopy should be included in the armamentarium for newly diagnosed gastric cancer in order to overcome the limitations of cross-sectional imaging in identifying sub-radiographic hepatic or peritoneal metastases. The benefit of surgical therapy is enhanced by at least 13% when it is integrated with multimodal therapy: either surgery followed by adjuvant chemoradiotherapy or surgery with perioperative systemic therapy. This multidisciplinary approach to treatment will continue to be an evolving paradigm, especially with the emergence of systemic and targeted therapies.
authors.affiliation: MedStar Georgetown University Hospital and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC.
authors.forename: Humair S
authors.initials: HS
authors.lastname: Quadri
authors.affiliation: MedStar Georgetown University Hospital and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC.
authors.forename: Young K
authors.initials: YK
authors.lastname: Hong
authors.affiliation: MedStar Georgetown University Hospital and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC.
authors.forename: Waddah B
authors.initials: WB
authors.lastname: Al-Refaie
mesh_terms: D014408:Biomarkers, Tumor; D000066491:Clinical Decision-Making; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D019468:Disease Management; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision; D009367:Neoplasm Staging / Q000379:methods; D010166:Palliative Care; D011300:Preoperative Care; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor