Gastric cancer

Gastric adenocarcinoma is the most common malignancy of the upper gastroint estinal tract. During the past two decades it has migrated toward the gastr esophageal junction, Gastresophageal reflux and obesity may play a role, Recent research suggest s that a number of biologic and molecular differences exist in patients wit h gastric cancer. Further investigation in these areas may help in predicti ng outcome and directing therapy. Gastric cancer is not a curable condition when metastases are present. Howe ver, postoperative chemotherapy plus chemoradiotherapy, in the Intergroup t rial 0116, prolonged the overall and disease-free survival rates of patient s after a curative (RO) resection, It should be considered the new standard of care in patients with gastric cancer who have undergone curative resect ion with stage Ib-IV disease. Preoperative therapy strategies may increase the likelihood of RO resection and remain an area of active investigation. Finally, development of more active agents is needed for the treatment of m etastatic tumors. (C) 2000 Lippincott Williams & Wilkins, Inc.