Published online Nov 7, 2015. doi: 10.3748/wjg.v21.i41.11609
Peer-review started: June 3, 2015
First decision: June 23, 2015
Revised: July 14, 2015
Accepted: September 15, 2015
Article in press: September 15, 2015
Published online: November 7, 2015
Although recent diagnostic and therapeutic advances have substantially improved the survival of patients with gastric cancer (GC), the overall prognosis is still poor. Surgery is the only curative treatment and should be performed in experienced centers. Due to high relapse following surgery, complementary and systemic treatment aimed at eradicating micrometastasis should be performed in most cases. Cytotoxic treatments are effective in downstaging locally advanced cancer, but different sensitivities and toxicities probably exist in different GC subtypes. Current treatment protocols are based primarily on clinical data and histological features, but molecular biomarkers that would allow for the prediction of treatment responses are urgently needed. Understanding how host factors are responsible for inter-individual variability of drug response or toxicity will also contribute to the development of more effective and less toxic treatments.
Core tip: There has been much progress in the past decades regarding the identification of risk factors for gastric cancer and understanding its pathogenesis. Diagnostic and therapeutic management of this disease has also improved significantly in the past few years. Despite these advances, prognosis remains dismal, and new therapeutic options are urgently needed. Hopefully, in the years to come, treatments will be tailored for a given patient based on tumor characteristics and host factors, with the aim of increasing therapeutic efficacy and decreasing toxicity. Faraway, so close!