Medical and surgical therapy for gastric cancer

Gastric cancer remains among the 10 most common cancers in the world with variations in incidence and survival based on geographic sites. Gastric cancer is the second most common tumor worldwide with 60% of cases in developing countries (1). It appears that, worldwide, gastric cancer is second only to lung cancer with a reported 798,300 new cases in 1990 and is more common than, breast and colorectal cancer outside of the United States. The highest incidences are in Japanese men; rates are also increased in eastern Europe, South America, and eastern Asia, but lower in the United States, North Africa, and Australia (1). In contrast, esophageal cancer is relatively rare, being the seventh leading cause of death in men in the United States (2). Survival is poor, being only 37% for stage II, 11-18% for stage III, and 5% for stage IV. The effectiveness of surgery, chemotherapy, radiation therapy or the combination of the above modalities has been investigated for decades with varied results.