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World J Gastroenterol. 2014 Feb 21;20(7):1635-49. doi: 10.3748/wjg.v20.i7.1635.

Treatment of gastric cancer.

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Michele Orditura, Vincenzo Sforza, Valentina Gambardella, Alessio Fabozzi, Maria Maddalena Laterza, Francesca Andreozzi, Jole Ventriglia, Beatrice Savastano, Fortunato Ciardiello, Ferdinando De Vita, Division of Medical Oncology, Dipartimento di Medicina, Clinica e Sperimentale 'F. Magrassi-A. Lanzara', Seconda Università degli Studi di Napoli, 80131 Naples, Italy.


The authors focused on the current surgical treatment of resectable gastric cancer, and significance of peri- and post-operative chemo or chemoradiation. Gastric cancer is the 4(th) most commonly diagnosed cancer and the second leading cause of cancer death worldwide. Surgery remains the only curative therapy, while perioperative and adjuvant chemotherapy, as well as chemoradiation, can improve outcome of resectable gastric cancer with extended lymph node dissection. More than half of radically resected gastric cancer patients relapse locally or with distant metastases, or receive the diagnosis of gastric cancer when tumor is disseminated; therefore, median survival rarely exceeds 12 mo, and 5-years survival is less than 10%. Cisplatin and fluoropyrimidine-based chemotherapy, with addition of trastuzumab in human epidermal growth factor receptor 2 positive patients, is the widely used treatment in stage IV patients fit for chemotherapy. Recent evidence supports the use of second-line chemotherapy after progression in patients with good performance status.


Adjuvant chemotherapy; Chemoradiation; Gastric cancer; Palliative chemotherapy; Radiotherapy; Surgery

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