Adelantos en el tratamiento del cáncer gástrico / Advances in the treatment of cancer of the stomach

ABSTRACT

Whereas the incidence of cancer of the stomach during the last years has been decreasing, nevertheless, its treatment still remains as a real challenge because more of the 80 % of the patients arrive to the attention with an advanced cancer, which makes that the prognosis remains poor and the mortality of gastric cancer has remained elevated. Surgery remains the mainstay of curative treatment; unfortunately, resection of all disease with negative margins, with no evidence of distant metastasis and on extensive lymph node dissection, is possible in only 30 to 40 % of newly diagnosed patients. The surgical resection performed with oncologic criterion is the only method that allows a complete recovering. The most important points to elucidate are: How extended should be the gastric resection? Until which level should embrace the lymph node emptying? In the total radical gastrectomy always is indicated the esplenectomy? Which is the value of the biopsy of the sentinel lymph node? It is possible to perform an oncologic resection by lapararoscopy? Is useful the multimodal treatment? These questions are analyzed in the article.