, Volume 15, Issue 4, pp 956-960,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 23 Jan 2008

More Controversy than Ever – Challenges and Promises Towards Personalized Treatment of Gastric Cancer

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Clinical decisions for the treatment of localized gastric cancer have become much more sophisticated and complicated than ever. Two recent large-scale trials published in NEJM for East Asian1 and Western patients2 strongly support the routine use of adjuvant chemotherapy. However, differences in design, extent of surgery, kind of chemotherapy timing of administration, and survival results in the two trials as well as potential differences in genetic background of Asian and Western gastric caner patients raise critical questions and grow confusion and uncertainty. Which is the optimum update treatment for Western patients?

Is the Japanese model with standardized D2 surgery followed by one year S-1 chemotherapy applicable in the West and can it produce similar excellent results or should treatment decisions be based on Western patient’s data from the UK MAGIC trial2 and the USA INT-0116 trial?3 This editorial approaches this critical question towards a live-saving decision. Emphasis is gi