Management of gastric cancer

Abstract

Background: Gastric cancer is a common disease with a high mortality.

Objective: This article aims to outline the management options for patients with gastric cancer.

Discussion: The mainstay of curative treatment remains surgical resection. The management of early stage gastric cancer is complex with proven benefit of both pre-operative chemotherapy and postoperative chemo-radiotherapy, as well as complex surgical issues and the patient benefits from management by a multidisciplinary team. The most commonly performed operations for gastric cancer are total and subtotal gastrectomy, depending on the location of the tumour and the ability to gain adequate tumour free margins. Common postoperative difficulties include early satiety, postprandial pain and diarrhoea, hypoglycaemic episodes and bile reflux. Adjuvant chemotherapy and radiotherapy has been demonstrated to have a beneficial role in survival. Palliative surgical options are directed at control of symptoms related to bleeding and obstruction. Palliative chemotherapy has been shown to confer a survival benefit, however, with notable toxicity.