Practice Guidelines in Oncology - Gastric Cancer
Practice Guidelines in Oncology - Gastric Cancer
Practice Guidelines in Oncology - Gastric Cancer
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®<br />
<strong>Practice</strong> <strong>Guidel<strong>in</strong>es</strong><br />
NCCN <strong>in</strong> <strong>Oncology</strong> – v.1.2007<br />
WORKUP<br />
� Multidiscipl<strong>in</strong>ary<br />
evaluation<br />
� H&P<br />
� CBC, platelets, SMA-12<br />
� Abdom<strong>in</strong>al CT<br />
� CT/ultrasound pelvis<br />
(females)<br />
� Chest x-ray<br />
� Esophagogastroduodenoscopy<br />
� PET/CT scana a<br />
b<br />
c<br />
CLINICAL<br />
PRESENTATION<br />
Locoregional<br />
(M0)<br />
Stage IV<br />
(M1)<br />
<strong>Gastric</strong> <strong>Cancer</strong><br />
Medically fit, b<br />
potentially<br />
resectable<br />
Medically fit, b<br />
unresectable<br />
Medically unfit<br />
May not be appropriate for T1 or M1 patients.<br />
Medically able to tolerate major abdom<strong>in</strong>al surgery.<br />
Laparoscopy is performed to evaluate for peritoneal spread when consider<strong>in</strong>g chemotherapy/RT or surgery.<br />
Laparoscopy is not <strong>in</strong>dicated if a palliative resection is planned.<br />
ADDITIONAL<br />
EVALUATION<br />
Cosider<br />
Laparoscopyc<br />
(category 2B)<br />
Note: All recommendations are category 2A unless otherwise <strong>in</strong>dicated.<br />
Cl<strong>in</strong>ical Trials: NCCN believes that the best management of any cancer patient is <strong>in</strong> a cl<strong>in</strong>ical trial. Participation <strong>in</strong> cl<strong>in</strong>ical trials is especially encouraged.<br />
Version 1.2007, 03/09/07 © 2007 National Comprehensive <strong>Cancer</strong> Network, Inc. All rights reserved. These guidel<strong>in</strong>es and this illustration may not be reproduced <strong>in</strong> any form without the express written permission of NCCN.<br />
<strong>Guidel<strong>in</strong>es</strong> Index<br />
<strong>Gastric</strong> Table of Contents<br />
Stag<strong>in</strong>g, MS, References<br />
Postlaparoscopy<br />
Stag<strong>in</strong>g (see GAST-2)<br />
Salvage Therapy<br />
(see GAST-4)<br />
GAST-1
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