Molecular Biologic Substaging of Gastric Cancer
Conference Recording Mar 30, 2013
AbstractThe biology of gastric cancer remains poorly understood. Although lymph node metastases, tumor location, histologic type, Borrmann classes, and blood tumor markers have been known to be correlated with prognosis, knowledge regarding individual prognostic factors provides limited information on the biology of the disease. Further, because of the internal correlations among the aforementioned factors in multivariate analysis, the prognostic value of many of these parameters is less established. The TNM staging system for gastric cancer provides a framework for the assessment of prognosis and the assignment of appropriate therapy. In the era of molecular biology, however, the traditional TNM system must be transformed to actively relate to the new information about tumor biology to improve the risk stratification and to guide targeted therapy. Integration of molecular information to the current anatomic staging system will refine subsets of patients in the same stage group. This would facilitate the biologically tailored treatment according the unique biology of tumor. Thus, the future edition of TNM for gastric cancer requires blending current anatomic extent-driven information with molecular biological information that will identify subgroups appropriate for targeted therapy. Here, I will discuss molecular biological substaging of gastric cancer whether the cancer specific molecular signatures can provide actionable information that stratifies patients into biologically homogeneous subgroups in relation to TNM system.