# Lymph Node Involvement in Advanced Gastric Cancer in the Era of Multimodal Treatment-Oncological and Surgical Perspective.

**Tumor:** Cáncer gástrico/UGE
**Autores:** Pelc Z, Sk&#xf3;rzewska M, Rawicz-Pruszy&#x144;ski K et al
**Revista:** Cancers (Basel) (2021)
**PMID:** 34065596 | **PMCID:** PMC8160868
**DOI:** [10.3390/cancers13102509](https://doi.org/10.3390/cancers13102509)
**Fuente:** PubMed Central (open access)

## Relevancia
Cáncer gástrico/UGE tratado con quimioterapia perioperatoria (FLOT/MAGIC) o inmunoterapia: documenta downstaging ganglionar, valor pronóstico de ypN0 y rendimiento ganglionar tras NAC. Comparable al paradigma mamario: ypN0 tras quimioterapia neoadyuvante es marcador pronóstico fuerte y guía la linfadenectomía D2.

## Abstract
Gastric cancer (GC) continues to be one of the major oncological challenges on a global scale. The role of neoadjuvant chemotherapy (NAC) in GC is to downstage primary tumour, eliminate potential micrometastases, and increase the chance for radical resection. Although systemic treatment prolongs the survival in advanced GC, persistent lymph node (LN) metastases indicate poor prognosis. Further identification of prognostic factors after NAC is urgent and could positively influence clinical outcomes. This article aimed to review the actual trends and future perspectives in multimodal therapy of advanced GC, with a particular interest in the post-neoadjuvant pathological nodal stage. A favourable prognostic impact for ypN0 patients is observed, either due to truly negative LN before the start of therapy or because preoperative therapy achieved a pathologically complete nodal response. Ongoing trials investigating the extent of lymphadenectomy after neoadjuvant therapy will standardise the LN dissection from the multimodal therapy perspective. Since downstaged and primarily node-negative patients show a similar prognosis, the main target for NAC in advanced GC should be nodal clearance. Adequate staging and personalised perioperative therapy seem to be of great importance in the multimodal treatment of GC.

## Acceso
Disponible en PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC8160868/

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*Datos de PubMed. Citar: doi 10.3390/cancers13102509*
