Gastric Cancer Etiology and Management in Asia and the West

Annu Rev Med. 2019 Jan 27:70:353-367. doi: 10.1146/annurev-med-081117-043436. Epub 2018 Oct 24.

Abstract

Regional variation in treatment paradigms for gastric adenocarcinoma has attracted a great deal of interest. Between Asia and the West, major differences have been identified in tumor biology, implementation of screening programs, extent of surgical lymphadenectomy, and routine use of neoadjuvant versus adjuvant treatment strategies. Minimally invasive techniques, including both laparoscopic and robotic platforms, have been studied in both regions, with attention to safety, feasibility, and long-term oncologic outcomes. The purpose of this review is to discuss advances in the understanding of the etiology and underlying biology of gastric cancer, as well as the current state of management, focusing on the differences between Asia and the West.

Keywords: adjuvant therapy; gastric adenocarcinoma; geographic differences; global variation; minimally invasive surgery.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adenocarcinoma / etiology*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / physiopathology
  • Adenocarcinoma / therapy*
  • Asia
  • Cultural Characteristics
  • Disease Management
  • Disease-Free Survival
  • Europe
  • Female
  • Gastrectomy / methods
  • Gastroscopy / methods
  • Humans
  • Lymph Node Excision / methods
  • Male
  • Neoadjuvant Therapy / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Robotic Surgical Procedures / methods
  • Stomach Neoplasms / etiology*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / physiopathology
  • Stomach Neoplasms / therapy*
  • Survival Analysis
  • United States