Staging systems for gastric cancer: more complex than TNM

Gastric cancer is an aggressive malignancy with varying incidences worldwide. Accurate staging systems are necessary in order to help determine prognosis and guide treatment. Given the rapidly evolving role of multi-modal systemic (chemotherapy, targeted therapy) and regional (chemoradiation) therapy in both the neoadjuvant and adjuvant setting, there is an even greater need for comprehensive and accurate prognostic staging systems.