Summary
Definição
História e exame físico
Principais fatores diagnósticos
- abdominal pain
- weight loss
- lymphadenopathy
Outros fatores diagnósticos
- age 50-70 years
- male sex (later-onset gastric cancer)
- female sex (early-onset gastric cancer)
- smoking
- family history
- nausea
- dysphagia
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
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
Investigações a serem consideradas
- endoscopic ultrasound
- endoscopic resection
- laparoscopy
- PET/CT scan
- liquid biopsy
Algoritmo de tratamento
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.
Declarações
VR and PD declare that they have no competing interests.
Revisores
Theodore Hong, MD
Director
Gastrointestinal Radiation Oncology
Massachusetts General Hospital Cancer Center
Boston
MA
Declarações
TH declares that he has no competing interests.
Andreas Leodolter, MD
Head of Department
Department of Gastroenterology
Sana Klinikum
Remscheid
Germany
Declarações
AL declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
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 Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao 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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