Stomach cancer is the fifth most common malignancy, the fourth cause of cancer death.
In 2020 there were one million new diagnoses of gastric cancer in the world, with 770,000 deaths;
in Italy 23,000 new diagnoses and about 8,500 deaths.
There are many new frontiers: the innovations that emerged at the recent International Gastric Cancer Congress in Houston were the focus of a discussion of the greatest Italian experts in the round table promoted by the Association "Living without a stomach is possible".
"Immunotherapy is opening up very interesting perspectives in the treatment of stomach cancer at an advanced stage - declares Domenico D'Ugo, director of the General Surgery Complex Operating Unit, of the Gemelli Polyclinic in Rome - especially for some categories of patients with particular structures genetic such as the alteration called 'microsatellite instability' that not all laboratories are able to study and which is predictive of non-response to chemotherapy.
Surgery remains central in the treatment of stomach cancer and the evidence confirms the efficacy of minimally invasive surgery, highly recommended in selected cases.
We are beginning to talk about onco-surgery or precision surgery: in this case too we aim at immunotherapy in the presence of a particular histological type that is becoming predominant in peritoneal carcinosis.
"The attempt - explains Giovanni De Manzoni, Director of the Esophagus and Stomach Complex Surgery Unit of the Verona University Hospital - is to use immunotherapy also as a loco-regional treatment during surgery or interspersed with traditional chemotherapy always in onco-surgery ".
At the World Congress, as well as adjuvant medical therapies and surgery, there was much discussion of supportive therapies.
"We are aware - comments Claudia Santangelo, president of 'Living without a stomach you can' - of the critical issues that still prevent our country from intercepting this neoplasm early: the lack of an early diagnosis and the absence of a defined diagnostic-therapeutic path of reference Centers recognized at regional level ".