GASTRIC-CANCER

Gastric cancer remains one of the most common causes of cancer mortali ty worldwide, despite a decline in incidence in Western countries. An important recent finding has been the recognition of an association be tween Helicobacter pylori and gastric cancer. The mechanisms, however, by which H. pylori infection and other environmental factors influenc e gastric tumorigenesis remain to be elucidated. The recent identifica tion of growth factors and their receptors has provided insights into the regulation of cell growth, proliferation, and differentiation. Fur thermore, studies of the effects and interactions of growth factors, o ncogenes, and tumor suppressor genes on biological behavior of human g astric cancers are in progress and may aid in therapeutic decision-mak ing. Fortuitously, molecular analysis requires small amounts of tumor tissue, which can be obtained from endoscopic biopsies. Regarding the treatment of gastric cancer, promising data on the use of neoadjuvant chemotherapy to increase surgical resectability have been obtained. Ho wever, locoregional failure continues to be the major obstacle and the addition of adjuvant intraperitoneal chemotherapy is specifically aim ed at this problem. Novel therapeutic approaches are clearly needed in the management of advanced disease in view of the relatively poor res ults thus far with available compounds.