Prognostic factors of gastric carcinoma

Abstract

Gastric carcinoma is the second most common cancer in the world. Adenocarcinoma of the stomach has a rate of incidence of 21% in men and 9% in women in Navarra and represents the fifth most common. The incidence of gastric cancer has decreased during the last decades. Although the causes of this decline are unknown, adenocarcinoma of the stomach appears to be related to the environment factors. Several specific patiens conditions appear to be associated with an increased risk of gastric cancer: age, socio-economic status and the weight loss. Multiple factors associated with the tumor include histologic type, tumor invasion of the gastric wall, lymph nodes involvement, tumor markers (CEA; Ca 19.9...), biologic factors as gen p53 mutations, the urokynase-type plasminogen activator system and the angiogenesis. Another prognostic factors have been correlated with the type treatment: total or subtotal gastrectomy, the extent of lymphadenectomy or the adjuvant treatment with chemoradiation. Although the majority of patients are diagnosed at a locally advanced or metastasis disease, the identification of prognostic factors has attracted particular interest to select different treatment modalities in an attempt to increase tumor response and survival.