Standard Treatment Surgery is the treatment of choice, although how extensive the operation has to be depends on the tumor's location and how much of the stomach is involved.
If the lesion is not in the area where the stomach joins the esophagus and does not diffusely involve the stomach, about three-quarters of the lower part of the stomach is removed (a radical subtotal gastrectomy). This treatment is associated with improved survival over other procedures.
When the lesion does involve the top of the stomach (cardia), cure may be attempted by removing most or all of the stomach, along with a sufficient length of the esophagus.
If the lesion diffusely involves the stomach, the entire stomach has to be removed along with, at a minimum, the greater and lesser omentum (fatty tissue) and nearby lymph nodes and the valve between the stomach and the duodenum (pylorus).
Five-Year Survival 52 to 85 percent for distal cancers (stomach outlet); 10 to 15 percent for proximal cancers (stomach entry)
Investigational
• Clinical trials of adjuvant combination chemotherapy and/or radiotherapy are appropriate whenever the tumor
invades to the serosa or local lymph nodes either grossly or microscopically (Stage IB) to try to improve the
survival. One adjuvant mitomycin-C trial has shown improved survival.
