Gastric Cancer

  • Charlotte Dai Kubicky
  • Jennifer S. Yu
  • Hans T. Chung


22,710 new cases and 11,780 deaths from gastric cancer each year in the US. Highest death rates are reported in Chile, Costa Rica, Japan, China, and the former Soviet Union. Median age of diagnosis is 65. Male:female = 1.5:1. Etiology and possible risk factors: low fruits and vegetables, high salts and nitrates, salted fish, smoked meats, Helicobacter pylori, hypochlorohydria, polyps, genetic alterations (p53 mutation, microsatellite instability, E-cadherin gene), previous radiation, gastrectomy, and pernicious anemia.


Pernicious Anemia Concurrent Chemoradiation Surgical Clip Linitis Plastica Smoke Meat 
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.



We thank Richard M. Krieg, MD, for his valuable ­advice in the preparation of this chapter.



  1. Ajani JA, Winter K, Okawara GS, et al. Phase II trial of preoperative chemoradiation in patients with localized gastric adenocarcinoma (RTOG9904): Quality of combined modality therapy and pathologic response. J Clin Oncol 2006;24:3953-3958.PubMedCrossRefGoogle Scholar
  2. Bonenkamp JJ, Hermans J, Sasako M, et al. Extended lymph-node dissection for gastric cancer. N Engl J Med 1999 Mar 25;340(12):908-914.PubMedCrossRefGoogle Scholar
  3. Cunningham D, Alum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11-20.PubMedCrossRefGoogle Scholar
  4. Cuschieri A, Weeden S, Fielding J, et al. Patient survival after D1 and D2 resections for gastric cancer: long-term results of the MRC randomized surgical trial. Surgical Co-operative Group. Br J Cancer 1999;79:1522-1530.CrossRefGoogle Scholar
  5. Degiuli M, Sasako M, Calgaro M, et al. Morbidity and mortality after D1 and D2 gastrectomy for cancer: interim analysis of the Italian Gastric Cancer Study Group (IGCSG) randomised surgical trial. Eur J Surg Oncol 2004;30:303-308.PubMedCrossRefGoogle Scholar
  6. 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 Feb;209(2):162-166.Google Scholar
  7. 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;22:2069-2077.PubMedCrossRefGoogle Scholar
  8. 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;345:725-730.PubMedCrossRefGoogle Scholar
  9. Macdonald JS, Smalley SR, Benedetti J, et al. Postoperative combined radiation and chemotherapy improves disease-free survival (DFS) and overall survival (OS) in resected adenocarcinoma of the stomach and gastroesophageal junction: Update of the results of Intergroup Study INT-0116 (SWOG 9008). American Society of Clinical Oncology Gastrointestinal Cancers Symposium, Abstract no. 6, 2004.Google Scholar
  10. Macdonald JS, Benedetti J, Smalley S, et al. Chemoradiation of resected gastric cancer: A 10-year follow-up of the phase III trial INT0116(SWOG 9008). 2009 American Society of Clinical Oncology Annual Meeting, Abstract no. 4515, 2009.Google Scholar
  11. National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Gastric Cancer. Available at: Accessed on May 29, 2009.
  12. Sano T, Sasako M, Yamamoto S, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy – Japan Clinical Oncology Group study 9501. J Clin Oncol 2004;22:2767-2773.PubMedCrossRefGoogle Scholar
  13. Sasako M, Sano T, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer – JCOG 9501. N Engl J Med 2008;359:453-462.PubMedCrossRefGoogle Scholar
  14. Tepper, JE, Gunderson, LL. Radiation treatment parameters in the adjuvant postoperative therapy of gastric cancer. Semin Radiat Oncol 2002;12:187-195.PubMedCrossRefGoogle Scholar
  15. Wu CW, Hsiung CA, Lo SS, et al. Nodal dissection for patients with gastric cancer: a randomised controlled trial. Lancet Oncol 2006 Apr;7(4):309-315.Google Scholar

Further Reading

  1. National Cancer Institute. Phase III randomized study of adjuvant chemoradiation after resection in patients with gastric or gastroesophageal adenocarcinoma.
  2. Soybel D, I, Zinner M, J. Stomach and Duodenum: Operative Procedures. In: Zinner M, J, Schwartz S, I, Ellis H, editors. Maingot’s Abdominal Operations. 10th ed: Stamford: Appleton and Lange; 1997. pp. 1079-1127.Google Scholar
  3. Willett CG, Gunderson LL. Stomach. In: Halperin EC, Perez CA, Brady LW, et al., editors. Principles and Practice of Radiation Oncology. 5th ed: Philadelphia: Lippincott Williams & Wilkins; 2007. pp. 1318-1335.Google Scholar

Copyright information

© Springer-Verlag New York 2010

Authors and Affiliations

  • Charlotte Dai Kubicky
    • 1
  • Jennifer S. Yu
    • 2
  • Hans T. Chung
    • 3
  1. 1.Radiation MedicineOregon Health and Science UniversityPortlandUSA
  2. 2.Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Radiation Oncology, Sunnybrook Odette Cancer CentreUniversity of TorontoTorontoCanada

Personalised recommendations