Approach to Gastric Cancers

All gastric carcinomas are originated from foveolar (stem/basal) cells, in practice. The most important development in this field is the detection of H.pylori’s role in the development of chronic gastritis as an important etiological factor. In most examples, they develop on the ground of intestinal metaplasia and chronic atrophic gastritis, and led by various stages of dysplasia, carcinoma in situ, and carcinoma. The incidence of gastric carcinoma shows geographical differences distribution. Especially in some countries like Japan and Columbia, the incidence of gastric carcinoma is greater than other countries. Patients are mostly asymptomatic in the early stage. Gastric carcinomas spread into the depths of the gastric wall. Early gastric carcinoma and advanced gastric carcinoma are divided into. Adeno Ca histological grading made according to the degree of differentiation at the gland direction. Stage of the disease, condition of lymph nodes, and penetration degree of the tumor tissue in the gastric wall are important factors that determine the prognosis. Factors affecting prognosis in gastric cancer are; invasion depth (mucosal, submucosal spread, gastric wall), lymph node metastasis, and lesion size. The five year survival rate in patients with gastric adenocarcinoma is on average 10-15%. Endoscopic mucosal resection in the treatment of early gastric cancer has been becoming more widespread in recent years and its prognosis is very good. It should be carefully examined with endoscopic ultrasonography before the endoscopy to ensure that these lesions are not overflown outside submucosa. In advanced gastric patients that do not have any chance of curative surgery, various multiple chemotherapy regimens are tried.