Gastric Cancer

Gastric cancer in eastern populations tends to occur at a younger age, and patients present at an earlier stage and generally have fewer co-morbid medical conditions. Elucidation of the molecular pathogenesis of gastric cancer has provided targets for novel rationally designed targeted anti-cancer drugs. Endoscopic ultrasonography provides accurate T staging and in particular, can accurately predict mucosal and sub-mucosal invasion of gastric cancer. Cytotoxic chemotherapy is an effective palliative treatment for advanced gastric cancer, providing symptomatic and quality-of-life benefits and prolongation of survival. Immune checkpoint inhibitors have shown promising activity, with durable responses seen in a subset of patients with advanced gastric cancer in recent clinical trials. The conclusion on surgical management of gastric cancer is that only complete resection can currently offer a cure for the disease, and the trend towards more careful selection of patients suitable for curative resection must be welcomed.