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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2015; 21(41): 11609-11620
Published online Nov 7, 2015. doi: 10.3748/wjg.v21.i41.11609
Towards curative therapy in gastric cancer: Faraway, so close!
Marília Cravo, Catarina Fidalgo, Rita Garrido, Tânia Rodrigues, Gonçalo Luz, Carolina Palmela, Marta Santos, Fábio Lopes, Rui Maio
Marília Cravo, Catarina Fidalgo, Rita Garrido, Tânia Rodrigues, Gonçalo Luz, Carolina Palmela, Marta Santos, Fábio Lopes, Rui Maio, Gastroenterology Department, Surgery and Oncology Clinics, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal
Author contributions: Cravo M, Fidalgo C, Garrido R, Rodrigues T, Luz G, Palmela C, Santos M and Lopes F wrote the manuscript; and Maio R reviewed the final version of the manuscript; all authors have contributed equally to this work.
Conflict-of-interest statement: No conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marília Cravo, MD, PhD, Gastroenterology Department, Surgery and Oncology Clinics, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal. marilia.cravo@hbeatrizangelo.pt
Telephone: +351-919-439192 Fax: +351-219-847209
Received: June 2, 2015
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
Abstract

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.

Keywords: Gastric cancer, Multidisciplinary treatment, Therapeutic strategies, Curative surgery

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!