文档介绍：Goals of the Revised Gastric Cancer Staging System
Despite declining incidence in the United States and many other western countries, gastric cancer continues to be a worldwide health problem, with more than 600,000 cases reported annually, far higher than pancreatic cancer with 125,000 cases. The highest rates occur in Japan, China, Eastern Europe, and South America, with 42% of worldwide cases occurring in
Development of an evidence-based universally applicable staging system for gastric carcinoma is challenging for a number of reasons. For instance, evidence is accumulating that the anatomic location of the primary tumor in the stomach influences survival, with tumor location in the antrum or distal stomach associated with better  This influence of tumor location means that any system best suited for TNM staging of distal gastric tumors may not be ideal for staging more proximal tumors, which are monly seen in western countries. Thus, any data set used for development or refinement of a gastric cancer staging system should incorporate cases from both Asian and western countries, or should be tested on such a set for validation purposes, if the goal is development of a TNM system applicable worldwide. In addition, two-thirds of gastric cancers occur in developing countries,1 and to be widely applicable a staging system must be based on data elements easil