Carcinogenesis and treatment of gastric cancer

Gastric cancer is the second most common cause of cancer-related death and, despite a decreasing incidence in the USA and Europe, overall it remains one of the most frequent cancers worldwide. Helicobacter pylori infection is has been recognized to be the leading cause of both intestinal and diffuse type distal gastric cancer, yet only 1% of colonized individuals develop malignancy. H. pylori strain characteristics and host genetics influence the risk of cancer development by differentially affecting the strength and the pattern of the host inflammatory response. Patients usually present with advanced disease, in which a curative treatment approach is often not possible. However, resection of the cancer remains the most important treatment option. In recent years, neoadjuvant treatment approaches have been developed and led to an improved overall survival. The introduction of novel targeted agents is a promising strategy which will further improve the prognosis of patients with advanced tumour stages.