2nd May 2024

A 58-year-old man presents with persistent epigastric pain and weight loss over the past 3 months.

A 58-year-old man presents with persistent epigastric pain and weight loss over the past 3 months. An upper endoscopy reveals a 3 cm ulcerated lesion in the distal stomach. Biopsy confirms adenocarcinoma. CT scan shows no distant metastasis but involvement of regional lymph nodes. The patient has a good performance status and no other significant comorbidities.

Which is the most appropriate management for this patient?