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What Are the Treatment Options for Gastric Cancer?

Aug 18, 2021 Source: Cainiu Health
Dr. Wu Xuehui
Introduction
Treatment options for gastric cancer include: 1. Surgical treatment, which comprises curative surgery and palliative surgery. 2. Chemotherapy, primarily used preoperatively, intraoperatively, and postoperatively in conjunction with curative surgery to prolong survival. 3. Targeted therapy, which selectively damages cancer cells while minimizing harm to normal cells. However, currently available targeted therapeutic agents for gastric cancer are limited in both variety and efficacy.

1. Surgical treatment: Surgical management of gastric cancer includes curative (radical) surgery and palliative surgery. The principle of curative surgery is en bloc resection, involving removal of the tumor along with part or all of the stomach—including any portion of the gastric wall potentially infiltrated by the tumor—as well as systematic lymphadenectomy of perigastric lymph nodes according to clinical staging criteria, followed by gastrointestinal reconstruction. Palliative surgery is performed when the primary tumor cannot be resected, aiming to alleviate symptoms caused by complications such as obstruction, perforation, or hemorrhage. Examples include gastrojejunostomy, jejunostomy, and perforation repair.

Currently, laparoscopic radical gastrectomy for gastric cancer has become increasingly standardized and yields favorable outcomes; it is now the predominant surgical approach for curative treatment of gastric cancer.

2. Chemotherapy: Chemotherapy is primarily used preoperatively (neoadjuvant), intraoperatively, and/or postoperatively (adjuvant) following curative resection to prolong survival. In patients with advanced gastric cancer, appropriately selected chemotherapy regimens can slow tumor progression, alleviate symptoms, and provide meaningful clinical benefit. For patients with early-stage gastric cancer who have undergone curative resection, adjuvant chemotherapy is generally not required; however, it may be considered in cases featuring high-grade histopathology, tumor size >5 cm, multiple synchronous lesions, or age <40 years—these constitute indications for adjuvant chemotherapy after early gastric cancer surgery. Adjuvant chemotherapy is routinely recommended following curative resection for locally advanced gastric cancer.

3. Targeted therapy: Targeted agents specifically impair cancer cells while minimizing damage to normal tissues. However, currently available targeted therapies for gastric cancer remain limited in both number and efficacy.

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