1. Academic Validation
  2. Gastric cancer

Gastric cancer

  • Lancet. 2020 Aug 29;396(10251):635-648. doi: 10.1016/S0140-6736(20)31288-5.
Elizabeth C Smyth 1 Magnus Nilsson 2 Heike I Grabsch 3 Nicole Ct van Grieken 4 Florian Lordick 5
Affiliations

Affiliations

  • 1 Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Hill's Road, Cambridge, UK. Electronic address: elizabeth.smyth2@nhs.net.
  • 2 Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden; Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.
  • 3 Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, Netherlands; Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
  • 4 Department of Pathology, Amsterdam University Medical Centre, Cancer Center Amsterdam, VU University, Amsterdam, Netherlands.
  • 5 University Cancer Center Leipzig, Leipzig University Medical Center, Leipzig, Germany.
Abstract

Gastric Cancer is the fifth most common Cancer and the third most common cause of Cancer death globally. Risk factors for the condition include Helicobacter pylori Infection, age, high salt intake, and diets low in fruit and vegetables. Gastric Cancer is diagnosed histologically after endoscopic biopsy and staged using CT, endoscopic ultrasound, PET, and laparoscopy. It is a molecularly and phenotypically highly heterogeneous disease. The main treatment for early gastric Cancer is endoscopic resection. Non-early operable gastric Cancer is treated with surgery, which should include D2 lymphadenectomy (including lymph node stations in the perigastric mesentery and along the celiac arterial branches). Perioperative or Adjuvant chemotherapy improves survival in patients with stage 1B or higher cancers. Advanced gastric Cancer is treated with sequential lines of chemotherapy, starting with a platinum and fluoropyrimidine doublet in the first line; median survival is less than 1 year. Targeted therapies licensed to treat gastric Cancer include trastuzumab (HER2-positive patients first line), ramucirumab (anti-angiogenic second line), and nivolumab or pembrolizumab (anti-PD-1 third line).

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