Updating controversies on the multidisciplinary management of gastric cancer.
The rates of relapse and death remain high in gastric cancer patients, especially in advanced stages. Local relapses in the tumour bed and regional lymph nodes, peritoneal spread as abdominal carcinomatosis, and distant metastasis are common mechanisms of failure after a R0 resection. To overcome this, a multidisciplinary approach has been prompted. In recent years, multidisciplinary treatment has been strengthened by some randomised controlled trials and it is now considered the standard by most groups, although the improvement in long-term survival rates achieved is still limited. This new therapeutic approach in gastric cancer is rapidly evolving and has led to a series of controversies on the best strategy to follow. Some of these controversies are discussed in this paper.
Lacueva
Javier
J
Servicio de Cirugía, Hospital General Universitario de Elche, Departamento de Patología y Cirugía, Universidad Miguel Hernández, Elche, Alicante, Spain. fj.lacueva@umh.es
Gallego
Javier
J
Díaz-González
Juan Antonio
JA
D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D006801:Humans; D011878:Radiotherapy; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000628:therapy*
D000970:Antineoplastic Agents