Clinical impact of underutilization of adjuvant therapy in node positive gastric adenocarcinoma

In 2017, the American Cancer Society estimates that there will be 28,000 new diagnoses of gastric adenocarcinoma and 10,960 deaths from this disease in the United States (1). The clinical outcome of gastric adenocarcinoma is strongly influenced by the status of nodal metastases, and this variable is an important determinant of overall survival. Despite the heterogeneity of outcomes in studies across the globe, lymph node involvement remains an important prognostic indicator for recurrence and survival (2-7). Patients with node negative cancer historically experience 5-year overall survivals ranging from 65–85% while the presence of N2 or N3 disease substantially decreases this range to 20–35% (8-11)