Oncoguía de cáncer gástrico 2023

Abstract

Gastric cancer ranks fifth in incidence worldwide, and Mexico is the sixth most frequent malignant neoplasm. Risk factors associated with gastric cancer are age (> 65 years), being male, a diet high in salt and nitrates, smoked and processed meats, vitamin C deficiency, smoking, heavy alcohol consumption, and infection by H. pylori and Bar Epstein virus. In Western countries, gastric cancer is associated with obesity and gastroesophageal reflux disease, predominantly proximal or in the cardia. The clinical picture is nonspecific in the early stages. Endoscopy allows biopsy for histopathological confirmation. Endoscopic treatment is the best option in tumors confined to the mucosa due to the high resectability rate, the organ´s appearance, and low recurrence. Surgical treatment is the best alternative for locoregional oncological control in the locally advanced stage. Likewise, the benefit of perioperative chemotherapy has been demonstrated. Adjuvant chemotherapy is recommended for patients without previous treatment and who initially underwent a total gastrectomy. Unresectable or metastatic advanced gastric cancer has a poor prognosis, although it has recently improved. This oncoguía included recommendations for diagnosis, staging, and treatment based on our Instituto Nacional de Cancerología´s experience and the most recently published evidence.