The management of gastric cancer: Overview

Alberto Redaelli, Davide Radice, Marco Turini

Research output: Contribution to journalArticle

Abstract

Background: Recent estimates of incidence indicate that gastric cancer (GC) is the second most frequent cancer (9.9% of cases) in the world with approximately 800,000 new cases diagnosed every year. GC was the seventh most frequent cause of cancer mortality in the United States in 2000. Objective: To provide a comprehensive overview of the management of GC including epidemiology, treatment options, quality of life (QoL) and cost issues as available from the international scientific and economic literature. Materials and Methods: A large-spectrum literature research was conducted, which aimed at highlighting the most important issues that have emerged during the last decade regarding GC and that are amenable to be developed into review topics. Results: Death rates have dramatically decreased during the last 60-70 years. Recent advances in patient care have also decreased post-operative mortality rates from over 50 to 4% for distal gastrectomy in Europe and to 0.6% in Japan. Significant evidences exist, so that the disease onset could be determined by genetic risk factors (e.g. Familial Adenomatous Polyposis - FAP; Cowden's syndrome), bacterial infection (e.g. Helicobacter pylori) or be enhanced by customary habits (e.g. fats, alcohol, smoke). GC is difficult to cure, because it is usually diagnosed in a relatively advanced stage when disease symptoms arise. Prognosis of the disease is poor, with only 40% of patients eligible to undergo potentially curative surgery. Even in those patients who undergo complete resection, the rate of recurrence is very high. Treatment options include surgery, chemotherapy, and radiation therapy either alone or in combination, but also new approaches are pursued to possibly prevent this deadly disease (e.g. screening, life-style habits, vaccines). The economic impact of this disease, substantially unexplored, cannot be considered marginal. GC management, regardless of the therapy option selected, creates a significant burden to patient QoL. Conclusions: Our findings suggest that GC, even if declining in terms of number of people affected and mortality rates still represent one of the most deadly malignancy in the world. General accepted consensus about the optimal management and therapy of this disease is still lacking. We advocate the need of a significant effort by healthcare providers, payers and other interested parties to determine the economic and humanistic burden posed by this disease, respectively, to the Society and the patient.

Original languageEnglish
Pages (from-to)185-197
Number of pages13
JournalGastrointestinal Oncology
Volume4
Issue number4
DOIs
Publication statusPublished - Dec 2002

Keywords

  • Cancer management
  • Economics
  • Epidemiology
  • Gastric cancer
  • Quality of life

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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