Treatment method | Stratification* | Grade I recommendations | Grade II recommendations | Grade III recommendations |
---|---|---|---|---|
Postoperative adjuvant treatment | pT3–4NanyM0 pTanyN + M0 R0 D2 resection |
Postoperative adjuvant chemotherapy: XELOX (Evidence 1A) S-1 alone (Evidence 1A) |
Postoperative adjuvant chemotherapy: FOLFOX (Evidence 2A) SOX (Evidence 2A) |
Postoperative adjuvant chemotherapy: XP (Evidence 2B) Postoperative adjuvant chemoradiotherapy: DT 45–50.4 Gy (concurrent fluoropyrimidine) (Evidence 3) |
pT2-4NanyM0, R0 resection; Failing to meet criteria for D2 |
Postoperative chemoradiotherapy: DT 45–50.4 Gy (concurrent fluoropyrimidine) (Evidence 1A) | MDT discussion for optimal treatment regimen | ||
pT2-4NanyM0 R1/R2 resection | Postoperative chemoradiotherapy: DT 45 to 50.4 Gy (concurrent fluoropyrimidine) | MDT discussion for optimal treatment regimen |
XELOX oxaliplatin (xeloda) + capecitabine, FOLFOX leucovorin calcium (folinic acid) + fluorouracil + oxaliplatin, SOX S-1 + oxaliplatin, XP capecitabine + cisplatin
* According to the 8th AJCC/UICC pathological staging system (pTNM) for gastric cancer