Clinical management of gastric cancer: results of a multicentre survey

A questionnaire asking the treatment options for gastric cancer cases was sent to 394 Chinese oncology specialists, including surgical oncologists, medical oncologists, and radiation oncologists working in hospitals joined in The Western Cooperative Gastrointestinal Oncology Group of China. The questionnaire involved a series of clinical scenarios regarding the interpretation of surgery, neoadjuvant, adjuvant, and advanced treatment planning of gastric cancer.Analysis of 358 respondents (91%) showed variations between each specialization and from the recommended guidelines in the management approaches to specific clinical scenarios. The majority of specialists admitted that less than 50% of patients received multidisciplinary evaluation before treatment. The participants gave different responses to questions involving adjuvant, neoadjuvant, and advanced settings, compared to the recommended guidelines.These results highlight the heterogeneity of the treatment of gastric cancer. Surgical oncologists, medical oncologists, and radiation oncologists are not adhering to the recommended guidelines.Despite the downward trend for cancer incidence and mortality in most countries, gastric cancer has become the second leading cause of cancer-related deaths worldwide with an annual rate of 700,000 deaths [1]. Almost two-thirds of the cases occur in developing countries, with 42% occurring in China alone, where gastric cancer remains the most deadly cancer among both sexes [2].Surgical resection, chemotherapy and radiotherapy are mainstay of treatment for patients with gastric cancer [3-5]. However, several questions concerning the treatment of gastric cancer remain. First, the type of resection and the role of extensive lymphadenectomy have been the subjects of international debate. Second, is there an ideal setting or regimen that predicts whether chemotherapy and/or radiotherapy should be provided before and/or after surgery as (neo) adjuvant treatment in patients with locali