Gastric Cancer in Japan — Honing Treatment, Seeking Causes

In this issue of the Journal, Sasako and colleagues (pages 453–462) present results from a randomized trial of surgery for gastric cancer conducted in 24 specialized hospitals in Japan. The 523 enrolled patients all had a diagnosis of curable gastric cancer and were randomly assigned to receive either Japan's standard surgical treatment — gastrectomy plus extensive removal of regional lymph nodes — or the same procedure plus para-aortic nodal dissection. There were no significant differences between the two groups in either overall 5-year survival (around 70% in both groups) or recurrence-free survival (around 63% in both groups). Given these results, . . .