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Abstract
The overall cure rate for gastric cancer has changed relatively little in the United
States over the past 30 years, largely because patients continue to present for treatment
in advanced stages. The paucity of symptoms in early gastric cancer, the low incidence
in the general United States population, and the lack of cost-effective screening
methods suggest that improvements in early detection are unlikely. Hope for improved
survival in late stage cases lies mostly in a better understanding of the pathophysiology
and patterns of spread, in evolving techniques for more accurate perioperative staging,
and in the gradually improving results of multimodality therapy for local-regional
and systemic disease. A proposal is made for a new staging system integrating newer
approaches to staging and for controlled trials of multimodality therapy in patients
unlikely to be cured by surgery alone.
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© 1989 Published by Elsevier Inc.
