Surgical and endoscopic treatment of invasive gastric cancer

The treatment of gastric cancer is complex and clinical practice varies by institution and region. For most patients with potentially resectable gastric cancer, options include perioperative (neoadjuvant and adjuvant) systemic therapy plus surgery or upfront surgery followed by adjuvant (postoperative) systemic therapy. This algorithm discusses local treatment options including endoscopic or surgical methods. The use of (neo)adjuvant therapy is not included in the discussion. Furthermore, some experts recommend the use of diagnostic staging laparoscopy in locally advanced cases or in all patients. Refer to UpToDate content on neoadjuvant treatment of gastric cancer and diagnostic staging laparoscopy for more details.