Treatment of cT1 Gastric Cancer with Submucosal Invasion or Regional Lymph Node Involvement (No Distant Metastasis)
Clinical Scenario
This protocol addresses resectable gastric cancer that has not spread to distant organs, across three specific presentations:
- cT1 gastric cancer with submucosal invasion and no distant metastasis
- cT1 gastric cancer with regional lymph node metastasis and no distant metastasis
- cT2–cT3 N0 gastric cancer with no distant metastasis
Surgical Approach
The standard treatment is surgical resection: gastrectomy combined with lymph node dissection. The extent of lymph node dissection is determined by clinical staging, with an emphasis on achieving negative resection margins.
The full staging-specific dissection protocol is available via the link below.
References
DOI: 10.5230/jgc.2025.25.e11
- Surgical resection with D2 LN dissection is the standard treatment for gastric cancer.
- D1+ dissection can be performed during surgery for EGC (cT1N0) patients in terms of survival outcomes.
- D2 dissection has been considered the standard LN dissection based on long-term survival data of the Dutch trial.
- Efforts to achieve negative margins are recommended to improve survival outcomes in EGC patients.
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