GASTRIC CANCER

GASTRIC CANCER

Carcinoma of the stomach is a major cause of mortality world - wide. Its prognosis tends to be poor, with cure rates little better than 5–10%, although better results are obtained in Japan, where the disease is common. Gastric cancer is actually an eminently curable disease and early diagnosis is key to success. Unfortunately , la te presentation is common and the cause of poor overall survival figures. The only curative treatment is resectional surgery . Summary box 67.6 Gastric cancer /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF y

Gastric cancer is one of the most common causes of cancer death The outlook is generally poor, owing to the advanced stage at presentation Better results are obtained in Japan, which has a high population incidence, screening programmes and high-quality surgical treatment The aetiology of gastric cancer is multifactorial H. pylori is important in distal but not proximal gastric cancer Early gastric cancer is associated with high cure rates Gastric cancer can be classi /f_i ed into intestinal and diffuse types, the latter having a worse prognosis Spread may be by lymphatics, blood, transcoelomic or direct Distant metastases are uncommon in the absence of lymph node involvement Radical surgery and removal of second tier of nodes (around the principal arterial trunks) may be advantageous Chemotherapy improves survival in patients having surgery and in advanced disease