[Cancers of the stomach]

Although its declining incidence in most Western countries, gastric cancer remains a leading cause of cancer death. In France, it ranks second after colorectal cancer in terms of frequency. Chronic gastritis is the most frequent pathological condition that predispose to gastric cancer. One of the most important aetiological factor of gastric carcinogenesis is obviously the infection by Helicobacter pylori. Positive diagnosis of gastric cancer is made by upper gastrointestinal endoscopy combined with biopsies. Surgical resection is currently the only potentially curative treatment. However, the 5-year-survival rate after apparently curative surgical resection remains only 15% in Western populations. The studies on adjuvant treatment after surgical resection, have failed to demonstrate any improvement in overall or disease-free survival. Although promising in the locally advance setting, the pre-operative cytotoxic approach with or without radiation therapy remains experimental. In advanced disease the so-called ECF regimen results in delayed symptoms-free survival, increased survival (median: 9 months) and better quality of life.