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Updated: Feb 16, 2026
Author Spotlight: Genetic Profiling for Fluorouracil Response in Gastric Cancer
Published on: May 10, 2024
[Diagnosis, staging and therapy of gastric cancer]
1Klinik für Innere Medizin, Diakonie-Krankenhaus, Schwäbisch Hall. Markus.Menges@diaksha.de
Abstract:
In spite of a continuously decreasing incidence in Western countries, gastric cancer remains a major health problem world-wide and a leading cause of cancer-related deaths. The molecular pathogenesis of the vast majority of sporadic tumours has not yet been clarified in detail, while for some familial cancer types causal germline mutations have been identified. Only radical resection offers a chance of cure and the prognosis is determined by the stage of disease at diagnosis. Unfortunately, about two-thirds of patients are still diagnosed in a late stage. The results of surgery have reached a plateau of effectiveness, in stages III and IV (UICC) an R0 resection will be possible in only about 40 % of cases and even, after successful curative resection, the prognosis is limited due to a high recurrence rate. The benefit of neoadjuvant chemotherapy in locally advanced cancers has been verified in phase II studies. Less clear is the adjuvant situation - the benefit of adjuvant radiochemotherapy after systematic lymphadenectomy awaits to be proven. In the palliative situation platinum-based high-dose 5-FU infusion protocols are currently the standard therapy.
Insights
Gastric cancer is a global health issue, often diagnosed late. While surgery offers cure, advanced stages have poor outcomes, necessitating improved treatment strategies.
Area of Science:
- Oncology
- Gastroenterology
Context:
- Gastric cancer remains a significant global health concern, despite declining incidence in Western nations.
- Late-stage diagnosis (two-thirds of patients) limits curative treatment options and impacts prognosis.
- Current surgical outcomes for advanced stages (UICC III-IV) show limited R0 resection rates (approx. 40%) and high recurrence rates.
Purpose:
- To review the current landscape of gastric cancer treatment, highlighting challenges and areas for further research.
- To discuss the effectiveness of surgical resection, neoadjuvant chemotherapy, and adjuvant therapies.
- To outline standard palliative care protocols for advanced gastric cancer.
Summary:
- Radical surgical resection is the only curative option for gastric cancer, but its effectiveness is limited in advanced stages.
- Neoadjuvant chemotherapy shows promise in locally advanced disease, while the role of adjuvant radiochemotherapy requires further investigation.
- Platinum-based high-dose 5-FU infusion protocols are the current standard for palliative care in advanced gastric cancer.
Impact:
- Highlights the critical need for earlier diagnosis and improved therapeutic strategies for gastric cancer.
- Identifies gaps in evidence for adjuvant therapies, suggesting areas for future clinical trials.
- Provides an overview of current treatment standards, aiding clinicians in managing gastric cancer patients.
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