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Seom guidelines for the treatment of gastric cancer 2015

M Martin-Richard1, A Custodio2, C García-Girón3

  • 1Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, 167, 08025, Barcelona, Spain. mmartinri@santpau.cat.

Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
|December 23, 2015
PubMed

Insights

Gastric cancer is a major health issue, with distinct treatments for gastroesophageal junction tumors. Early endoscopic resection and neoadjuvant/adjuvant therapies improve survival for advanced gastric cancer.

Area of Science:

  • Oncology
  • Gastroenterology
  • Molecular Biology

Background:

  • Gastric cancer represents a significant mortality cause in Spain.
  • Emerging molecular data suggest gastroesophageal junction tumors are distinct from gastric cancer, necessitating different prognoses and treatments.
  • Early-stage gastric tumors are amenable to endoscopic resection.

Purpose of the Study:

  • To review current treatment strategies for gastric cancer, including early, locally advanced, and stage IV disease.
  • To highlight the importance of differentiating gastroesophageal junction tumors from gastric cancer.
  • To summarize evidence supporting neoadjuvant/adjuvant therapies and first- and second-line treatments for advanced gastric cancer.

Main Methods:

  • Literature review of molecular biology findings and clinical studies on gastric cancer and gastroesophageal junction tumors.
  • Analysis of treatment outcomes for various stages of gastric cancer.
  • Evaluation of therapeutic regimens, including endoscopic resection, neoadjuvant/adjuvant therapy, and chemotherapy (platinum-fluoropyrimidine, trastuzumab).

Main Results:

  • Endoscopic resection is a viable option for very early gastric tumors.
  • Neoadjuvant and adjuvant therapies demonstrably improve overall survival in locally advanced, resectable gastric cancer.
  • Platinum-fluoropyrimidine regimens, augmented with trastuzumab for HER2-overexpressing tumors, are the standard first-line treatment for stage IV gastric cancer.
  • Second-line therapies have shown significant survival benefits in randomized studies.

Conclusions:

  • Gastric cancer and gastroesophageal junction tumors require distinct management approaches.
  • Standardized treatment protocols, including surgery, neoadjuvant/adjuvant therapies, and targeted chemotherapy, are crucial for improving patient survival.
  • Ongoing research into second-line treatments offers further improvements for advanced gastric cancer patients.
Keywords:
CardiaClinical guidelinesDiagnosisGastric adenocarcinomaTreatment

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