Management of Gastric Cancer

Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.

1. Natural history of surgically treated gastric cancer.- 2. Pathology and cytology of gastric cancer.- 3. Rationale for the intraperitoneal approach to surgical adjuvant chemotherapy of gastric cancer.- 4. Endoscopy in gastric malignancy.- 5. Surgical treatment of gastric cancer.- 6. Staging of gastric cancer: clinical, surgical, and pathological.- 7. Recent developments in diagnostic radiology of primary and recurrent gastric cancer.- 8. In-vitro chemosensitivity testing of human gastric adenocarcinoma.- 9. The rationale for early postoperative intraperitoneal chemotherapy for gastric cancer.- 10. Induction chemotherapy using intraarterial infusion.- 11. Treatment of gastric cancer.- 12. Cancer of the cardia: The value of total extended esophago-gastrectomy.- 13. Radiation therapy for gastric carcinoma.- 14. Early postoperative intraperitoneal chemotherapy for gastric cancer.- 15. Early postoperative intraperitoneal adriamycin as an adjuvant treatment for advanced gastric cancer with lymph node or serosal invasion.- 16. Gastric cancer in Korea: Experience at the Seoul National University Hospital.- 17. New trends in therapy for gastric malignancy.- 18. Tumor biology and quality of life in patients with gastric cancer.- 19. The surgical treatment of gastric cancer with special reference to systematic lymph node dissection.- 20. Celiac axis infusion (CAI) chemotherapy for advanced gastric cancer.- 21. New developments in the treatment of gastric carcinoma.