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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2016; 22(3): 1139-1159
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.1139
Advanced gastric cancer: What we know and what we still have to learn
Federico Coccolini, Giulia Montori, Marco Ceresoli, Simona Cima, Maria Carla Valli, Gabriela E Nita, Arianna Heyer, Fausto Catena, Luca Ansaloni
Federico Coccolini, Giulia Montori, Marco Ceresoli, Gabriela E Nita, Luca Ansaloni, Department of General Surgery, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
Simona Cima, Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Simona Cima, Maria Carla Valli, Radiation Oncology Unit, Oncology Institute of Southern Switzerland, 6500 Bellinzona, Switzerland
Arianna Heyer, University of California, Berkeley, CA 94720-5800, United States
Fausto Catena, Department of General and Emergency Surgery, Maggiore hospital, 43100 Parma, Italy
Author contributions: Coccolini F, Montori G, Ceresoli M and Ansaloni L designed research; Coccolini F, Montori G, Ceresoli M, Ansaloni L, Catena F, Cima S, Valli MC, Nita GE and Heyer A analyzed data; Coccolini F, Montori G, Ceresoli M, Ansaloni L, Catena F, Cima S, Valli MC and Nita GE wrote the paper; Heyer A revise the english language; all authors read and approved the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Federico Coccolini, MD, Department of General Surgery, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy. federico.coccolini@gmail.com
Telephone: +39-35-2673486 Fax: +39-35-2674963
Received: May 29, 2015
Peer-review started: June 6, 2015
First decision: August 26, 2015
Revised: September 25, 2015
Accepted: November 24, 2015
Article in press: November 24, 2015
Published online: January 21, 2016
Processing time: 231 Days and 1.4 Hours
Abstract

Gastric cancer is a common neoplastic disease and, more precisely, is the third leading cause of cancer death in the world, with differences amongst geographic areas. The definition of advanced gastric cancer is still debated. Different stadiating systems lead to slightly different stadiation of the disease, thus leading to variations between the single countries in the treatment and outcomes. In the present review all the possibilities of treatment for advanced gastric cancer have been analyzed. Surgery, the cornerstone of treatment for advanced gastric cancer, is analyzed first, followed by an investigation of the different forms and drugs of chemotherapy and radiotherapy. New frontiers in treatment suggest the growing consideration for intraperitoneal administration of chemotherapeutics and combination of traditional drugs with new ones. Moreover, the necessity to prevent the relapse of the disease leads to the consideration of administering intraperitoneal chemotherapy earlier in the therapeutical algorithm.

Keywords: Advanced gastric cancer; Chemotherapy; Hypertermic intraperitoneal chemotherapy; Intraperitoneal; Surgery; Definition

Core tip: New frontiers in treatment suggest the growing consideration for intraperitoneal administration of chemotherapeutics and combination of traditional drugs with new ones. Moreover, the necessity to prevent the relapse of the disease leads to the consideration of administering intraperitoneal chemotherapy earlier in the therapeutical algorithm.