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Staging of Gastric Cancer: Current Revision and Future Proposal

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Abstract

Gastric cancer (GC) is the fourth most common malignancy and ranks the third as cause of death (990,000 cases, 738,000 deaths) worldwide (ref. [1] WHO). Due to the lack of cost-effective screening test and the lack of specific symptoms, most gastric cancer cases were diagnosed at the advanced stages. It is very important to appropriately stage GC patients since it is associated with the choice of treatment modalities and patients’ prognosis. The current staging modalities include endoscopy, CT, PET/CT, and laparoscopy. The primary goals of the staging are to evaluate whether a patient has regional or distant metastasis (M), whether the tumor involves local/regional lymph nodes (N), and whether the depth of tumor invasion into the different histology layers between mucosa and serosa (T). Combining the three components, Union for International Control Cancer (UICC)/American Joint Committee on Cancer (AJCC) has defined the most commonly used GC staging system, tumor-node-metastasis (TNM) staging system [1]. As the improvement in cancer awareness, methods in cancer screening, advancement in chemotherapy and target therapy, and patients’ disease characteristics are constantly changing and so does the prognosis. Hence, the UICC/AJCC TNM staging system has been revised accordingly every few years since its induction into clinical practice since 1977. The seventh edition UICC/AJCC TNM classification for GC was modified after the Buffalo Meeting 2008 as the result of the consensus between the Eastern (Japanese and Korean) and Western GC classification. In 2010, the seventh edition (7th ed.) TNM classification for GC, comprising of the data from Japan and Korean, was published with minor revisions in T stage and major revisions in N stage compared to the previous editions of TNM classification [2].

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Authors and Affiliations

  1. Department of Gastroenterology, Tianjin Medical University Cancer Hospital, City Key Laboratory of Tianjin Cancer Center and National Clinical Research Center for Cancer, Tianjin, China

    Jingyu Deng & Han Liang

  2. Hepatobiliary Cancer, Division of Surgery Oncology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Jiping Wang

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  1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea (Republic of)

    Sung Hoon Noh

  2. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea (Republic of)

    Woo Jin Hyung

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Deng, J., Wang, J., Liang, H. (2019). Staging of Gastric Cancer: Current Revision and Future Proposal. In: Noh, S., Hyung, W. (eds) Surgery for Gastric Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45583-8_2

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