Gastric cancer is the fourth most commonly diagnosed cancer and the second most common cause of cancer death worldwide, with an estimated 989,600 new cases and 738,000 deaths in 2008 (Kamangar, Dores, and Anderson 2006; ACS 2011). Gastric cancer incidence varies throughout the world, with Japan and Korea having the highest incidences (Crew and Neugut 2006). In the U.S., 21,600 new cases and 10,990 deaths are estimated for 2013 (ACS 2013). There are two main sites of gastric cancer: cardia (proximal, gastroesophageal junction) and noncardia (fundus, body, distal, and lesser or greater curvature). The incidence of noncardia tumors is decreasing, possibly due to lower incidence of H. Pylori infection caused by improved diet, food storage, and overall sanitation (Parsonnet et al. 1991). H. Pylori infection is a major etiologic factor in the development of intestinal type gastric cancer (Parsonnet et al. 1991). Nonetheless, the incidence of proximal tumors has been increasing since the 1970s, suggesting etiologic heterogeneity among gastric malignancies (Wu et al. 2009).
Most patients with this tumor present with inoperable, locally advanced, or metastatic disease (SEER Stat Fact Sheet: Stomach, accessed 2012). Diagnosis is often delayed because many patients with early stage disease present with vague, non-specific symptoms or no symptoms at all. Late-stage disease at presentation, relative chemoresistance, and frequent co-morbidities causing poor functional status have contributed to poor overall survival (Okines and Cunningham 2010; Kim et al. 2012; Bang et al. 2010). Even patients with operable disease will only have about a one in three chance of surviving 5 years (McDonald et al. 2001; Cunningham et al. 2006). Metastatic disease is treated with systemic chemotherapy and supportive measures.
Last Updated: February 19, 2013
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