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01-01-2015 | Gastric cancer | Book chapter | Article

11. Gastric Cancer: Molecular Mechanisms, Diagnosis, and Treatment

Authors: M.D. Gopi K. Prithviraj, M.D., M.P.H. Khaldoun Almhanna

Publisher: Springer International Publishing

Abstract

Gastric cancer is one of the most frequently diagnosed cancers worldwide, with a relative 5 year survival of 27.7 %. The clinical outcome for advanced gastric cancer remains poor, with 5-year relative survival of only 3.9 %. Many risk factors have been identified in relation to gastric cancer, including Helicobacter pylori, Epstein-Barr virus infection, family history of gastric cancer, and the presence of pathologic changes such as atrophic gastritis, intestinal metaplasia, and high-grade dysplasia. At this time, the current standard of care in the first-line treatment of advanced or metastatic gastric cancer includes a platinum plus fluoropyrimidine backbone, while the primary treatment of early stage disease is resection with consideration for neoadjuvant, perioperative, or adjuvant chemotherapy. While early-stage gastric cancers may be successfully treated with surgical and medical therapy, metastatic gastric cancer continues to have a limited overall survival despite treatment. Herein we discuss the pathogenesis, screening, diagnosis, and treatment of gastric cancer, including future directions such as targeted therapies.

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