Improving survival in advanced gastric cancer: A qualitative approach

Purpose – Though the incidence and mortality numbers are comparatively less than other types of cancer, such as lung and breast cancer, overall survival in advanced gastric cancer cases is still very bleak, thus patients only receive palliative treatment. We sought to improve overall survival in gastric cancer patients by reviewing the various treatment protocols associated with advanced gastric carcinoma. Methodology- A retrospective analysis of several randomized trials and related literature collected from online medical databases was performed and all available regimens were evaluated for their influence on survival. Findings- Our analysis revealed chemotherapy followed by surgery to be the preferred protocol for treatment of gastric cancer(primary option), the exact selection of the agents and surgery involved being debatable. Immunotherapy and radiotherapy have recently been proved effective as adjunct and concurrent administration respectively in certain cases, thus appear as emerging treatment options. Second-line options, though limited, provide slight increment in survival. Thus, a possible treatment guideline has been proposed combining all facts. Research limitations/implications- For a more precise evaluation, more randomized trials over the past 10 years need to be analyzed. Thus more time is required. Practical implications- Our findings would enable us to accelerate the rather slow progress being made in the treatment of advanced gastric carcinoma and evaluate better treatment regimens and cost-effective ways in improving overall survival in such patients. Originality/value- Very few studies are available which review the effect of both chemotherapy and immunotherapy in advanced gastric cancer. Even less information or meta-analyses are available regarding radiotherapy and intraperitoneal chemotherapy in advanced gastric cancer, thus marking our study as a pivotal retrospective analysis.