Gastric cancer and intraperitoneal chemotherapy

Gastric cancer is a worldwide health problem and is second to lung cancer as the leading cause of cancer-related mortality. Over 90% of gastric cancers are adenocarcinomas, with the remaining 10% consisting of lymphomas, neuroendocrine tumors, and gastrointestinal stromal tumors. Considering all gastric adenocarcinomas, the incidence of adenocarcinoma of the distal stomach is falling, whereas the incidence of proximal adenocarcinomas, mainly of the gastric cardia, is rising. One of the main difficulties in treating gastric adenocarcinoma is the fact that diagnosis generally occurs at a late stage, especially in North American countries, related to low disease prevalence and lack of screening programs that exist in Asian countries. The treatment of gastric cancer is multimodal, as surgical, medical, and radiation treatments in isolation have not been found to be efficacious. When considering morbidity, the surgery alone group was more favorable compared to the surgery and intraperitoneal chemotherapy groups.