Gastric cancer

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 bio...

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Bibliographic Details
Published inThe Lancet (British edition) Vol. 396; no. 10251; pp. 635 - 648
Main Authors Smyth, Elizabeth C, Nilsson, Magnus, Grabsch, Heike I, van Grieken, Nicole CT, Lordick, Florian
Format Journal Article
LanguageEnglish
Published London Elsevier Ltd 29.08.2020
Elsevier Limited
Subjects
Angiogenesis
Antiangiogenics
Biomarkers
Biopsy
Cancer
Chemotherapy
Classification
Clinical medicine
Deep learning
Disease
Epidemiology
ErbB-2 protein
Gastric cancer
Genes
Genomes
Immunotherapy
Infections
Laparoscopy
Lymph nodes
Medical prognosis
Medical research
Medicin och hälsovetenskap
Mesentery
Monoclonal antibodies
Morphology
Mortality
Mutation
Nutrient deficiency
Patients
PD-1 protein
Pembrolizumab
Platinum
Proteins
Risk analysis
Risk factors
Surgery
Survival
Targeted cancer therapy
Trastuzumab
Ultrasound
Japan
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Summary: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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ISSN:0140-6736
1474-547X
1474-547X
DOI:10.1016/S0140-6736(20)31288-5