History of gastric cancer treatment: the pioneers, early misconceptions and the current guidelines <br><b>[Abstract in English]</b>

Abstract

AIMS: Gastric adenocarcinoma remains among the leading causes of death from cancer, with a 5-year survival rate of only 20% to 25%. Surgical resection is the only therapeutic option that may allow healing in patients affected by this malignancy. The objective of this study is to review the main aspects of the historical progression of knowledge about treatment of this disease. SOURCE OF DATA: A search was carried out at PubMed. Selected papers about the history, evolution and treatment of gastric cancer were reviewed. SUMMARY OF FINDINGS: Gastrectomy is a challenging surgical procedure which requires a high level of surgical expertise. This procedure has constantly evolved over the years through the meticulous efforts of a number of surgeons before reaching its current state. This review navigates through some of the early limitations and misconceptions and highlights the initial milestones which laid the foundation of this procedure. CONCLUSIONS: Complete resection of the tumor remains the standard treatment whenever possible. Depending on the location and stage of the tumor, either a subtotal distal or a total gastrectomy can be performed. The long-term benefit of systematic lymphadenectomy has now been shown in prospective randomized trials. Multimodal treatment strategies including chemotherapy and/or radiotherapy can further improve local and regional tumor control and lessen the rate of systemic metastasis.