Gastric cancer, also known as stomach cancer, is a malignant neoplasm that originates in the stomach lining. This type of cancer is characterized by slow development over several years.
Before the formation of an invasive carcinoma, precancerous changes usually occur in the inner lining (mucosa) of the stomach. These initial changes are usually asymptomatic, making early detection difficult.
Gastric cancer is the fifth most common type of cancer worldwide. Its treatment may include surgery, chemotherapy, radiotherapy and targeted therapies, depending on the stage and specific type of cancer.
IVOQA is formed by a multidisciplinary group of oncological surgeons, medical oncologists, nutritionists, radiologists, pathologists, psycho-oncologists… specialized in minimally invasive techniques and in the treatment of gastric cancer.
In this surgery only part of the stomach is removed. Sometimes along with part of the esophagus or, more frequently, the first part of the small intestine (first portion of the duodenum). The remaining section of the stomach is then reconnected to the small intestine. Part of the omentum (an apron-like layer of fatty tissue that hangs down from the stomach and transverse colon) is also removed along with the adjacent lymph nodes, and in some cases possibly the spleen.
This operation is used if the cancer has spread so far that a subtotal gastrectomy is not possible. It is also often recommended if the cancer is in the upper part of the stomach, near the esophagus.
Endoscopic resection via gastroscopy can be performed for premalignant lesions or in patients at high surgical risk and for follow-up and polyp removal.
Immunotherapy can be used in combination with chemotherapy in advanced stage disease and in certain specific contexts.
Chemotherapy is a common treatment for gastric cancer and can be used in different stages and situations.
Neoadjuvant. It is administered before surgery to reduce the size of the tumor and facilitate its removal.
Adjuvant. It is applied after surgery to eliminate any residual cancer cells and reduce the risk of recurrence.
Primary. In cases of advanced or metastatic gastric cancer, chemotherapy in combination with other techniques (such as PIPAC in case of peritoneal metastases) may be the primary treatment to reduce tumor size, alleviate symptoms, and prolong the patient's life.
This is a minimally invasive procedure used in the treatment of gastric cancer to assess the extent of disease within the abdomen. This type of surgery allows physicians to obtain a clear and detailed view of the affected area without the need for a large incision. It allows for lavage cytology to be performed and to detect if there are implants or peritoneal spread.
In the year 2024 the NCCN guidelines (Clinical Practice Guidelines in Oncology) included treatment with cytoreduction surgery and HIPEC in the approach to patients with peritoneal metastases of gastric origin with Peritoneal Cancer Index (PCI) less than or equal to 7. IVOQA has a team specialized in peritoneal pathology composed of surgical oncologists with extensive experience in cytoreduction surgery and a machine for perfusion of HIPEC.
In 2024 the NCCN guidelines (Clinical Practice Guidelines in Oncology) included PIPAC treatment for patients with gastric cancer and peritoneal metastases with PCI greater than 7, combining PIPAC with chemotherapy and/or systemic immunotherapy. IVOQA is one of the centers with the greatest experience in PIPAC in the national territory and in ePIPAC (pressurized aerosol intraperitoneal chemotherapy with electrostatic precipitation).
In this surgery only part of the stomach is removed. Sometimes along with part of the esophagus or, more frequently, the first part of the small intestine (first portion of the duodenum). The remaining section of the stomach is then reconnected to the small intestine. Part of the omentum (an apron-like layer of fatty tissue that hangs down from the stomach and transverse colon) is also removed along with the adjacent lymph nodes, and in some cases possibly the spleen.
This operation is used if the cancer has spread so far that a subtotal gastrectomy is not possible. It is also often recommended if the cancer is in the upper part of the stomach, near the esophagus.
Chemotherapy is a common treatment for gastric cancer and can be used in different stages and situations.
Neoadjuvant. It is administered before surgery to reduce the size of the tumor and facilitate its removal.
Adjuvant. It is applied after surgery to eliminate any residual cancer cells and reduce the risk of recurrence.
Primary. In cases of advanced or metastatic gastric cancer, chemotherapy in combination with other techniques (such as PIPAC in case of peritoneal metastases) may be the primary treatment to reduce tumor size, alleviate symptoms, and prolong the patient's life.
Most targeted therapies are used in advanced stages of gastric cancer, where the cancer has spread and cannot be completely removed by surgery.
IVOQA offers patients the most complete and advanced NGS panels. By analyzing a large number of tumor genes, specialist pathologists determine the therapies to which the tumor is most likely to be sensitive. We can perform NGS panels on biopsies previously obtained at other centers.
Immunotherapy can be used in combination with chemotherapy in advanced stage disease and in certain specific contexts.
The aim of palliative care is to alleviate the symptoms of the disease and to treat, as best as possible, the side effects of treatments so that patients can live with quality of life.
The treatment of gastric cancer requires a multidisciplinary approach, involving several specialists to ensure comprehensive and personalized care. IVOQA offers oncologic surgeons specialized in subtotal and total gastrectomy by minimally invasive routes, such as laparoscopy or robotic surgery, and in open surgery.
Patients with stomach cancer benefit from our prehabilitation programme and the advantages of the ERAS® protocols for optimal recovery.
The extensive experience of our team of surgical oncologists in minimally invasive surgery and stomach surgery makes IVOQA the leading facility for stomach cancer surgery and treatment.
The treatment of stomach cancer by highly specialised teams is crucial for achieving the best oncological and survival outcomes for our patients.
