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Gastric Cancer

Gastric Adenocarcinoma — Diagnosis, Staging, and Multimodal Therapy

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Gastric Cancer?

Gastric cancer is predominantly adenocarcinoma arising from gastric mucosa, subdivided into intestinal (Lauren) and diffuse types.

H. pylori chronic infection causes 70–80% of non-cardia gastric cancers; gastric cardia tumors relate more to GERD and obesity.

Early diagnosis is critical — survival drops sharply once lymph nodes involved; screening programs are cost-effective in high-incidence regions (Japan, Korea).

Biomarkers: HER2, MSI, PD-L1, and Claudin 18.2 guide targeted and immunotherapy.

Symptoms

Dyspepsia, epigastric pain, and early satiety
Unintentional weight loss and anorexia
Nausea, vomiting, and dysphagia (cardia or pyloric tumors)
Iron-deficiency anemia and melena from occult bleeding
Virchow node (left supraclavicular), Sister Mary Joseph nodule (umbilical), Krukenberg tumor (ovarian metastasis)
Paraneoplastic: acanthosis nigricans, Leser-Trélat sign, migratory thrombophlebitis

Risk Factors

Helicobacter pylori infection and chronic atrophic gastritis
High-salt, smoked, pickled, or nitrate-rich diet; low fruit/vegetable intake
Tobacco smoking and heavy alcohol
Family history and hereditary syndromes (CDH1, Lynch, Li-Fraumeni, FAP)
Pernicious anemia and partial gastrectomy
Male sex, age over 50, and blood group A

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Dyspepsia over age 50 or with alarm features (bleeding, weight loss, dysphagia, anemia)
  • Persistent vomiting, early satiety, or new onset iron-deficiency anemia
  • Family history of gastric cancer or hereditary diffuse gastric cancer syndrome

Treatment Methods

01
Upper endoscopy with multiple biopsies; staging with CT chest/abdomen/pelvis, endoscopic ultrasound, and diagnostic laparoscopy
02
Early gastric cancer (T1a): endoscopic submucosal dissection (ESD) in selected lesions
03
Resectable disease: perioperative FLOT chemotherapy plus gastrectomy (subtotal or total) with D2 lymphadenectomy
04
HER2-positive advanced: trastuzumab plus chemotherapy; Claudin 18.2 positive: zolbetuximab
05
Immunotherapy (nivolumab, pembrolizumab) for PD-L1 positive or MSI-high advanced tumors
06
H. pylori eradication for prevention; endoscopic surveillance for high-risk mucosal lesions and family history

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.