In this issue of JAMA Surgery, Chen et al1 add to an emerging understanding of biomarkers to determine individualized risk in gastric cancer. Early gastric cancer (EGC), in particular, requires precise risk stratification for more aggressive biology (ie, lymph node metastasis [LNM]). This concept is underscored by 3 findings: LNM has the strongest association with disease recurrence in resected EGC2; nodal positivity is reproducibly associated with disease-specific death3; and patients with T1a EGC are increasingly candidates for nonresectional interventions, such as endoscopic submucosal dissection, at expert centers.4
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Datta J, Strong VE. Toward More Accurate Understanding of Lymph Node Metastasis Risk in Early Gastric Cancer. JAMA Surg. 2019;154(3):e185250. doi:10.1001/jamasurg.2018.5250
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