Gastric Cancer

  • Alexandria T. Phan
  • Paul F. Mansfield


Gastric (stomach) cancer, the most frequently occurring cancer and second-leading cause of cancer-related deaths, accounts for 24.2 % of cancer deaths worldwide [1–3]. Adenocarcinoma accounts for the vast majority of gastric cancer cases, with the remaining minority consisting of lymphoma, sarcoma, carcinoid tumor, and squamous cell carcinoma; the treatment information in this chapter focuses only on adenocarcinoma, whereas the survival curves include patients with all histologies.


Gastric Cancer Gastric Cancer Patient Advanced Gastric Cancer Regional Disease Metastatic Gastric Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    International Agency for Research on Cancer (IARC). Accessed 23 May 2012.
  2. 2.
    Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.PubMedCrossRefGoogle Scholar
  3. 3.
    Shibata A, Parsonnet J. Stomach cancer. 3rd ed. New York: Oxford University Press; 2006.Google Scholar
  4. 4.
    Bosetti C, Malvezzi M, Chatenoud L, Negri E, Levi F, La Vecchia C. Trends in cancer mortality in the Americas, 1970–2000. Ann Oncol. 2005;16(3):489–511.PubMedCrossRefGoogle Scholar
  5. 5.
    Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59(4):225–49.PubMedCrossRefGoogle Scholar
  6. 6.
    Howson CP, Hiyama T, Wynder EL. The decline in gastric cancer: epidemiology of an unplanned triumph. Epidemiol Rev. 1986;8:1–27.PubMedGoogle Scholar
  7. 7.
    Coggon D, Barker DJ, Cole RB, Nelson M. Stomach cancer and food storage. J Natl Cancer Inst. 1989;81(15):1178–82.PubMedCrossRefGoogle Scholar
  8. 8.
    Talley NJ, Zinsmeister AR, Weaver A, et al. Gastric adenocarcinoma and Helicobacter pylori infection. J Natl Cancer Inst. 1991;83(23):1734–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Parsonnet J, Friedman GD, Vandersteen DP, et al. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med. 1991;325(16):1127–31.PubMedCrossRefGoogle Scholar
  10. 10.
    Fuchs CS, Mayer RJ. Gastric carcinoma. N Engl J Med. 1995;333(1):32–41.PubMedCrossRefGoogle Scholar
  11. 11.
    Lewis FR, Mellinger JD, Hayashi A, et al. Prophylactic total gastrectomy for familial gastric cancer. Surgery. 2001;130(4):612–7 [discussion 7–9].PubMedCrossRefGoogle Scholar
  12. 12.
    Huntsman DG, Carneiro F, Lewis FR, et al. Early gastric cancer in young, asymptomatic carriers of germ-line E-cadherin mutations. N Engl J Med. 2001;344(25):1904–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Chun YS, Lindor NM, Smyrk TC, et al. Germline E-cadherin gene mutations: is prophylactic total gastrectomy indicated? Cancer. 2001;92(1):181–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Edge SB, Byrd DR, Compton C, Fritz AG, Greene FL, Trotti A, editors. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.Google Scholar
  15. 15.
    SEER. SEER statistics facts sheet. Accessed 27 Dec 2009.
  16. 16.
    Bozzetti F, Marubini E, Bonfanti G, Miceli R, Piano C, Gennari L. Subtotal versus total gastrectomy for gastric cancer: five-year survival rates in a multicenter randomized Italian trial. Italian Gastrointestinal Tumor Study Group. Ann Surg. 1999;230(2):170–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Gouzi JL, Huguier M, Fagniez PL, et al. Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum. A French prospective controlled study. Ann Surg. 1989;209(2):162–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Maruyama K, Sasako M, Kinoshita T, Sano T, Katai H. Surgical treatment for gastric cancer: the Japanese approach. Semin Oncol. 1996;23(3):360–8.PubMedGoogle Scholar
  19. 19.
    Bonenkamp JJ, Hermans J, Sasako M, et al. Extended lymph-node dissection for gastric cancer. N Engl J Med. 1999;340(12):908–14.PubMedCrossRefGoogle Scholar
  20. 20.
    Hartgrink HH, van de Velde CJ, Putter H, et al. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch gastric cancer group trial. J Clin Oncol. 2004;22(11):2069–77.PubMedCrossRefGoogle Scholar
  21. 21.
    Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11–20.PubMedCrossRefGoogle Scholar
  22. 22.
    Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345(10):725–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357(18):1810–20.PubMedCrossRefGoogle Scholar
  24. 24.
    Ajani JA. Recent developments in cytotoxic therapy for advanced gastric or gastroesophageal carcinoma: the phase III trials. Gastrointest Cancer Res. 2007;1(Suppl):S16–21.PubMedGoogle Scholar
  25. 25.
    Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol. 2006;24(18):2903–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Moertel CG, Lavin PT. Phase II-III chemotherapy studies in advanced gastric cancer. Eastern Cooperative Oncology Group. Cancer Treat Rep. 1979;63(11–12):1863–9.PubMedGoogle Scholar
  27. 27.
    Schnitzler G, Queisser W, Heim ME, et al. Phase III study of 5-FU and carmustine versus 5-FU, carmustine, and doxorubicin in advanced gastric cancer. Cancer Treat Rep. 1986;70(4):477–9.PubMedGoogle Scholar
  28. 28.
    Klein HO, Wils J, Bleiberg H, Buyse M, Duez N. An EORTC gastrointestinal (GI) group randomized evaluation of the toxicity of sequential high dose methotrexate and 5-fluorouracil combined with adriamycin (FAMTX) vs 5-fluorouracil, adriamycin and mitomycin (FAM) in advanced gastric cancer. Med Oncol Tumor Pharmacother. 1989;6(2):171–4.PubMedGoogle Scholar
  29. 29.
    Barone C, Cassano A, Astone A, et al. Association of epirubicin, etoposide and cisplatin in gastric cancer. A phase II study. Oncology. 1991;48(5):353–5.PubMedCrossRefGoogle Scholar
  30. 30.
    Kim NK, Park YS, Heo DS, et al. A phase III randomized study of 5-fluorouracil and cisplatin versus 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil alone in the treatment of advanced gastric cancer. Cancer. 1993;71(12):3813–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Roth AD, Maibach R, Martinelli G, et al. Docetaxel (Taxotere)-cisplatin (TC): an effective drug combination in gastric carcinoma. Swiss Group for Clinical Cancer Research (SAKK), and the European Institute of Oncology (EIO). Ann Oncol. 2000;11(3):301–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol. 2006;24(31):4991–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Roth AD, Fazio N, Stupp R, et al. Docetaxel, cisplatin, and fluorouracil; docetaxel and cisplatin; and epirubicin, cisplatin, and fluorouracil as systemic treatment for advanced gastric carcinoma: a randomized phase II trial of the Swiss Group for Clinical Cancer Research. J Clin Oncol. 2007;25(22):3217–23.PubMedCrossRefGoogle Scholar
  34. 34.
    Al-Batran SE, Hartmann JT, Probst S, et al. Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, leucovorin plus either oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft Internistische Onkologie. J Clin Oncol. 2008;26(9):1435–42.PubMedCrossRefGoogle Scholar
  35. 35.
    Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358(1):36–46.PubMedCrossRefGoogle Scholar
  36. 36.
    Dank M, Zaluski J, Barone C, et al. Randomized phase III study comparing irinotecan combined with 5-fluorouracil and folinic acid to cisplatin combined with 5-fluorouracil in chemotherapy naive patients with advanced adenocarcinoma of the stomach or esophagogastric junction. Ann Oncol. 2008;19(8):1450–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Koizumi W, Narahara H, Hara T, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9(3):215–21.PubMedCrossRefGoogle Scholar
  38. 38.
    van Cutsem E, Kang YK, Chung H, et al. Efficacy results from the ToGA trial: a phase III study of trastuzumab added to standard chemotherapy (CT) in first-line human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (GC). J Clin Oncol. 2009;27(18s):LBA4509.Google Scholar
  39. 39.
    Vanhoefer U, Rougier P, Wilke H, et al. Final results of a randomized phase III trial of sequential high-dose methotrexate, fluorouracil, and doxorubicin versus etoposide, leucovorin, and fluorouracil versus infusional fluorouracil and cisplatin in advanced gastric cancer: a trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group. J Clin Oncol. 2000;18(14):2648–57.PubMedGoogle Scholar
  40. 40.
    Smith JK, McPhee JT, Hill JS, et al. National outcomes after gastric resection for neoplasm. Arch Surg. 2007;142(4):387–93.PubMedCrossRefGoogle Scholar
  41. 41.
    Brennan MF, Radzyner M, Rubin DM. Outcome—more than just operative mortality. J Surg Oncol. 2009;99(8):470–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Bare M, Cabrol J, Real J, et al. In-hospital mortality after stomach cancer surgery in Spain and relationship with hospital volume of interventions. BMC Public Health. 2009;9:312.PubMedCrossRefGoogle Scholar
  43. 43.
    Verhoef C, van de Weyer R, Schaapveld M, Bastiaannet E, Plukker JT. Better survival in patients with esophageal cancer after surgical treatment in university hospitals: a plea for performance by surgical oncologists. Ann Surg Oncol. 2007;14(5):1678–87.PubMedCrossRefGoogle Scholar
  44. 44.
    Smith DL, Elting LS, Learn PA, Raut CP, Mansfield PF. Factors influencing the volume-outcome relationship in gastrectomies: a population-based study. Ann Surg Oncol. 2007;14(6):1846–52.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of GI Medical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Surgical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

Personalised recommendations