Upper GI 2017

Ann Oncol 2013, Radiother Oncol 2014, Eur J Surg Oncol 2014

Gastric Cancer (Adenocarcinoma)

Operable Stage T1N0

Operable Stage >T1N0

Inoperable or Metastatic

Re-assess ?

Best supportive care

Consider EMR or limited resection

Pre-operative chemotherapy

Palliative chemotherapy

Surgery

if unfit for treatment

Her-2 negative: Platinum + Fluoropyrimidine- based doublet or triplet regimen

HER-2 positive: Trastuzumab + CF/CX

Consider clinical trials of novel agents

Adjuvant chemoradiation

Adjuvant chemotherapy

Surgery

2 nd line single agent chemo / trials if adequate PS

Post-operative chemotherapy