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Despite poor overall long-term survival in patients with gastric cancer, adjuvant therapy improves survival after gastrectomy. Adjuvant approaches include postoperative 5-fluorouracil chemotherapy and radiotherapy in the U.S., pre- and postoperative chemotherapy in Europe, and adjuvant chemotherapy in Asia. The role of postoperative radiotherapy in adjuvant management has been controversial, given that the quality of surgery varies between Eastern and Western countries. Also, some argue that the superior survival associated with systematic D2 lymph node resection — comprising removal of greater and lesser curvature, gastrohepatic, splenic, and celiac nodes — negates any potential benefit for postoperative radiotherapy.
To investigate this is…