Current Status of Management of Gastric Cancer

Gastric cancer is very common malignancy in India and most of these patients present to us when disease has already advanced. After Initial endoscopy, biopsy confirms the diagnosis and then CT scan is used to stage the disease. Where Laparoscopy facility is available, it is a good tool for clinical staging. Radical Gastrectomy remains the Gold Standard of treatment, nowadays. But still today there is a lot of controversy regarding the lymph node dissection in Gastrectomy. However, in India, there is a general standard practice of D2 Dissection with preservation of spleen and pancreas. Patients with R1 and R2 resection or with high risk of relapse are managed with post operative chemo radiation. However, Neoadjuvant Chemotherapy in Gastric cancer has come in a big way along with post gastrectomy Chemotherapy in recent past. Both these practice of Neoadjuvant and adjuvant Chemotherapy has been benefitting the patient by increasing the survival rate and decreasing the morbidity. Hence, these treatment modalities should be properly explained to patient before hand. And only after proper explanation of treatment options proper consent should be taken from patient and attendants to go ahead with treatment of Gastric cancers.