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Stomach cancer

Última revisão: 13 Dec 2025
Última atualização: 02 Dec 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • abdominal pain
  • weight loss
  • lymphadenopathy
Detalhes completos

Outros fatores diagnósticos

  • age 50-70 years
  • male sex (later-onset gastric cancer)
  • female sex (early-onset gastric cancer)
  • smoking
  • family history
  • nausea
  • dysphagia
Detalhes completos

Fatores de risco

  • Helicobacter pylori
  • pernicious anemia
  • immigration from high-incidence regions
  • foods containing N-nitroso compounds
  • male sex (later-onset gastric cancer)
  • female sex (early-onset gastric cancer)
  • diet low in fruits and vegetables
  • high-salt diet
  • smoking
  • family history
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • esophagogastroduodenoscopy with biopsy
  • CT of chest/abdomen/pelvis
  • CBC
  • comprehensive metabolic panel
  • Helicobacter pylori carbon-13 urea breath test or stool antigen test
  • molecular and pathological tests
Detalhes completos

Investigações a serem consideradas

  • endoscopic ultrasound
  • endoscopic resection
  • laparoscopy
  • PET/CT scan
  • liquid biopsy
Detalhes completos

Algoritmo de tratamento

AGUDA

localized: suitable for surgery

localized: not suitable for surgery

advanced and metastatic disease: HER2 overexpression positive

advanced and metastatic disease: HER2 overexpression negative

advanced and metastatic disease: MSI-H/dMMR tumors (independent of PD-L1 status)

advanced and metastatic disease: NTRK gene fusion-positive tumors

Colaboradores

Autores

Ahmed Abdelhakeem, MD

Fellow Physician

Department of Hematology and Oncology

Mayo Clinic - Mayo Clinic Comprehensive Cancer Center

Jacksonville

FL

Declarações

AA declares that he has no competing interests.

Mariela Blum Murphy, MD

Associate Professor

Department of GI Medical Oncology

University of Texas

MD Anderson Cancer Center

Houston

TX

Declarações

MBM declares that she has no competing interests.

Agradecimentos

Dr Ahmed Abdelhakeem and Dr Mariela Blum Murphy would like to gratefully acknowledge Dr Valerie Reed and Dr Prajnan Das, previous contributors to this topic.

利益声明

VR and PD declare that they have no competing interests.

同行评议者

Theodore Hong, MD

Director

Gastrointestinal Radiation Oncology

Massachusetts General Hospital Cancer Center

Boston

MA

Раскрытие информации

TH declares that he has no competing interests.

Andreas Leodolter, MD

Head of Department

Department of Gastroenterology

Sana Klinikum

Remscheid

Germany

Раскрытие информации

AL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: gastric cancer [internet publication].Полный текст

Lordick F, Carneiro F, Cascinu S, et al. Gastric cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022 Oct;33(10):1005-20.Полный текст  Аннотация

Статьи, указанные как источники

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