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Preoperative Work-up and Assessment of Resectability

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Surgery in the Multimodal Management of Gastric Cancer

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Abstract

Radical surgery consisting of gastrectomy and D2 lymphadenectomy remains the standard procedure in the treatment of gastric cancer. To improve outcome, neoadjuvant treatment strategies with chemo- and/or radiotherapy regimes are employed. The optimal treatment plan and overall prognosis are critically dependent on accurate assessment of local invasion, tumor size, lymph node involvement, and the presence or absence of distant metastases. Total body computed tomography (CT), gastroduodenal endoscopy, and endoscopic ultrasonography have all been used in the diagnosis and initial staging of gastric cancer, showing a moderate sensitivity and specificity for the detection of lymph node metastases. 18-FDG-positron emission tomography (PET)-CT has no role in the primary detection of gastric cancer due to its low sensitivity, but better accuracy than CT in the evaluation of lymph node metastases. A key staging modality in patients with gastric cancer is staging laparoscopy, which has high accuracy in detecting occult metastases and avoids the need for laparotomies.

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Author information

Authors and Affiliations

  1. Dept. of General and Emergency Surgery, University of Perugia, Perugia, Italy

    Annibale Donini

Authors
  1. Luigina Graziosi
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  2. Walter Bugiantella
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  3. Emanuel Cavazzoni
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  4. Annibale Donini
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Editor information

Editors and Affiliations

  1. Dept. of Surgery Upper G.I. Surgery Division, University of Verona, Verona, Italy

    Giovanni de Manzoni

  2. Dept. of Human Pathology and Oncology Section of General Surgery and Surgical Oncology Translational Research Laboratory, University of Siena, Siena, Italy

    Franco Roviello

  3. Surgical Clinic, Dept. of Medical and Surgical Sciences “Ospedali Riuniti” University Hospital, Polytechnic University of Marche, Ancona, Italy

    Walter Siquini

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© 2012 Springer-Verlag Italia

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Graziosi, L., Bugiantella, W., Cavazzoni, E., Donini, A. (2012). Preoperative Work-up and Assessment of Resectability. In: de Manzoni, G., Roviello, F., Siquini, W. (eds) Surgery in the Multimodal Management of Gastric Cancer. Springer, Milano. https://doi.org/10.1007/978-88-470-2318-5_7

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  • DOI: https://doi.org/10.1007/978-88-470-2318-5_7

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2317-8

  • Online ISBN: 978-88-470-2318-5

  • eBook Packages: MedicineMedicine (R0)

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