Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- abdominal pain
- weight loss
- lymphadenopathy
Otros factores de diagnóstico
- age 50-70 years
- male sex (later-onset gastric cancer)
- female sex (early-onset gastric cancer)
- smoking
- family history
- nausea
- dysphagia
Factores de riesgo
- 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- 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
Pruebas diagnósticas que deben considerarse
- endoscopic ultrasound
- endoscopic resection
- laparoscopy
- PET/CT scan
- liquid biopsy
Algoritmo de tratamiento
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
Divulgaciones
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
Divulgaciones
MBM declares that she has no competing interests.
Agradecimientos
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.
Divulgaciones
VR and PD declare that they have no competing interests.
Revisores por pares
Theodore Hong, MD
Director
Gastrointestinal Radiation Oncology
Massachusetts General Hospital Cancer Center
Boston
MA
Divulgaciones
TH declares that he has no competing interests.
Andreas Leodolter, MD
Head of Department
Department of Gastroenterology
Sana Klinikum
Remscheid
Germany
Divulgaciones
AL declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: gastric cancer [internet publication].Texto completo
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.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diagnósticos diferenciais
- Peptic ulcer disease
- Benign esophageal stricture
- Achalasia
Mais Diagnósticos diferenciaisDiretrizes
- NCCN clinical practice guidelines in oncology: genetic/familial high-risk assessment: colorectal, endometrial, and gastric
- Japanese gastric cancer treatment guidelines 7th edition
Mais DiretrizesFolhetos informativos para os pacientes
Endoscopy (upper gastrointestinal)
Mais Folhetos informativos para os pacientes
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