Prognosis in the Cancer of the Stomach

Although the incidence of gastric cancer has been declining in most industrialized countries over the past two decades, it still remains the second leading cause of cancer related deaths worldwide [1]. The incidence is highest in Japan, Korea, China, Latin America and Eastern Europe. In western countries like the United States, the incidence is lower, with 21,000 new cases diagnosed each year [2]. Gastric carcinoma is one of the most frequent malignancies in the world and its clinical behavior especially depends on the metastatic potential of the tumor. In particular, lymphatic metastasis is one of the main predictors of tumor recurrence and survival, and current pathological staging systems reflect the concept that lymphatic spread is the most relevant prognostic factor in patients undergoing curative resection [3]. This is compounded by the observation that two-thirds of gastric cancer in the Western world presents at an advanced stage, with lymph node metastasis at diagnosis [4].