Noe-Kyeong Kim

Gastric cancer in Korea: experience at the Seoul National University Hospital

Gastric cancer is the most common cancer in Korea and constitutes 24.2% of all malignancies, 29.6% of male tumors, and 17.8% of female tumors [1]. The annual incidence is 69.1 per 100,000 in males and 29.5 per 100,000 in females. The prognosis for gastric carcinoma continues to be unfavorable in this country. The annual death rates are 38.8 per 100,000 for male and 23.9 per 100,000 for female. Surgery can result in cures or longer disease free survivals in only a small number of patients, since most gastric carcinomas are diagnosed when the tumor is at an advanced stage. More than 50% of all patients with newly diagnosed gastric carcinoma at the Seoul National University Hospital (SNUH) had an unresectable, locally advanced disease, and/or distant metastases (Figure 1). While response rates in gastric cancer patients treated with a combination chemotherapy regimen are somewhat better than for colorectal cancer, complete responses are generally uncommon. Thus far, the only treatment that results in a significant cure of gastric cancer is surgery. As the result of surgery depends upon the stage of disease, only early detection has been the best method to cure gastric cancer up to now. In this chapter, we intend to summarize the biologic and pathologic characteristics of gastric cancer, data of detection with radiologic and endoscopic measures, and the results of surgical treatment and chemotherapy regimens utilized at SNUH.