What are the treatment options for gastric cancer?

Updated: May 21, 2019
  • Author: Elwyn C Cabebe, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Surgical resection is the principal therapy for gastric cancer, as it offers the only potential for cure. [4] The most common procedures are total, subtotal, or distal gastrectomy. The choice of procedure and the extent of nodal dissection are determined by the ability to obtain clear microscopic margins. In patients who present with regionally advanced disease, removal of involved adjacent organs (eg, the spleen) may be required.

Neoadjuvant chemotherapy has an established role in the management of gastric cancer. Perioperative chemotherapy, or postoperative chemotherapy plus chemoradiation, are preferred for localized gastric cancer. Because of lower toxicity, two-drug cytotoxic regimens (eg, fluoropyrimidine and oxaliplatin) are preferred for patients with advanced disease. [4]

For description of chemotherapy and chemoradiotherapy regimens, see Gastric Cancer Treatment Protocols.


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