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Gastric cancer and complications of relapsed disease: Gastric cancer and complications of relapsed disease Expert commentary John Bridgewater Expert commentary John Bridgewater 

Gastric cancer and complications of relapsed disease: Gastric cancer and complications of relapsed disease Expert commentary John Bridgewater Expert commentary John Bridgewater
Chapter:
Gastric cancer and complications of relapsed disease: Expert commentary John Bridgewater
Source:
Challenging Concepts in Oncology
Author(s):

Imran Petkar

DOI:
10.1093/med/9780199688883.003.0008

Gastric cancer is the fourth commonest cancer worldwide. Unfortunately, only a minority of patients present with localized operable disease. Survival rates, following surgery alone, are poor, and a number of multimodality approaches, including perioperative chemotherapy, adjuvant chemotherapy, and adjuvant chemoradiotherapy, have been adopted to improve cure rates. This case demonstrates the presentation of gastric cancer and the role of perioperative chemotherapy. The patient relapses, and the management of recurrent disease is discussed; recently, the benefits of second-line irinotecan or docetaxel for advanced disease have been established. A further improvement has been demonstrated with the addition of trastuzumab to first-line doublet chemotherapy for tumours overexpressing human epidermal receptor 2 (HER2), which is seen in about 20% of cases. Further understanding of tumour biology is fundamental to improve current outcomes from management of this aggressive disease.

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