Advanced Gastric Cancers

Abstract

Gastric cancer is one of the world’s leading causes of morbidity and mortality from malignant disease. Although gastric cancer-related mortality has declined dramatically since the 1930s, gastric cancer remains a lethal disease, especially when it is diagnosed at an advanced stage. In advanced gastric cancer, the lesion extends beyond the proper muscle layer. Advanced gastric cancers are usually classified into four types (types 1–4) by their gross appearance. If an ulcerative mass (types 2 and 3) is found, at least six to eight biopsy specimens from all quadrants of the ulcer margin and ulcer base are necessary to detect the carcinoma. The diffuse infiltrative form (type 4) is easily missed on endoscopic examination, and in many cases, results of histological examination may be negative, even on repetitive biopsy. Therefore, it is important to retrieve specimens from any abnormal mucosal areas such as redness, erosion, or tiny ulcer.