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World J Gastrointest Surg. Apr 27, 2014; 6(4): 55-58
Published online Apr 27, 2014. doi: 10.4240/wjgs.v6.i4.55
Multimodal treatment of gastric cancer
Ilaria Proserpio, Stefano Rausei, Sabrina Barzaghi, Francesco Frattini, Federica Galli, Domenico Iovino, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Graziella Pinotti
Ilaria Proserpio, Sabrina Barzaghi, Graziella Pinotti, Department of Oncology, Ospedale di Circolo and University of Insubria, 21100 Varese, Italy
Stefano Rausei, Francesco Frattini, Federica Galli, Domenico Iovino, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi, Department of Surgery, Ospedale di Circolo and University of Insubria, 21100 Varese, Italy
Author contributions: Proserpio I and Rausei S contributed to the design and conceptualization of the study and editing of the manuscript; Barzaghi S and Frattini F contributed to the drafting of the manuscript; Galli F and Iovino D contributed to the paper collection and analysis; Rovera F and Boni L contributed to the revision of the manuscript; Dionigi G and Pinotti G gave final approval of the manuscript.
Correspondence to: Stefano Rausei, MD, PhD, Department of Surgery, University of Insubria, Viale Borri 57, 21100 Varese, Italy. s.rausei@libero.it
Telephone: +39-332-278577 Fax: +39-332-260260
Received: October 29, 2013
Revised: January 30, 2014
Accepted: February 16, 2014
Published online: April 27, 2014
Processing time: 202 Days and 23.1 Hours
Abstract

Gastric cancer is the second leading cause of death from malignant disease worldwide. Although complete surgical resection remains the only curative modality for early stage gastric cancer, surgery alone only provides long-term survival in 20% of patients with advanced-stage disease. To improve current results, it is necessary to consider multimodality treatment, including chemotherapy, radiotherapy and surgery. Recent clinical trials have shown survival benefit of combining different neoadjuvant or adjuvant protocols compared with surgery with curative intent. Furthermore, the implementation of chemotherapy with novel targeted agents could play an important role in the multimodal management of advanced gastric cancer. In this paper, we focus on a multidisciplinary approach in the treatment of gastric cancer and discuss future strategies to improve the outcome for these patients.

Keywords: Gastric cancer; Gastrectomy; Lymphadenectomy; Multimodal treatment; Adjuvant therapy; Neoadjuvant therapy; Chemotherapy; Radiotherapy; Targeted therapy

Core tip: It is necessary to consider multimodality treatment, including chemotherapy, radiotherapy and surgery, to improve current results of gastric cancer treatment. Recent clinical trials have shown survival benefit combining different neoadjuvant or adjuvant protocols compared with curative surgery. Furthermore, the implementation of chemotherapy with novel targeted agents could play an important role in the multimodal management of advanced gastric cancer. In this paper, we focus on a multidisciplinary approach in the treatment of gastric cancer and discuss future strategies to improve the outcome for these patients.