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Ajani, Jaffer A; Bentrem, David J; Besh, Stephen; D'Amico, Thomas A; Das, Prajnan; Denlinger, Crystal; Fakih, Marwan G; Fuchs, Charles S; Gerdes, Hans; Glasgow, Robert E; Hayman, James A; Hofstetter, Wayne L; Ilson, David H; Keswani, Rajesh N; Kleinberg, Lawrence R; Korn, W Michael; Lockhart, A Craig; Meredith, Kenneth; Mulcahy, Mary F; Orringer, Mark B; Posey, James A; Sasson, Aaron R; Scott, Walter J; Strong, Vivian E; Varghese, Jr, Thomas K; Warren, Graham; Washington, Mary Kay; Willett, Christopher; Wright, Cameron D; McMillian, Nicole R; Sundar, Hema
Journal of the National Comprehensive Cancer Network, 2013-May-01, Volume: 11, Issue: 5Journal Article
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+.
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