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Gastric Cancer
(Adenocarcinoma)
Operable
Stage T1N0
Operable
Stage >T1N0
Inoperable or
Metastatic
Ann Oncol 2013, Radiother Oncol 2014,
Eur J Surg Oncol 2014
Consider EMR
or limited
resection
Pre-operative
chemotherapy
Surgery
Surgery
Post-operative
chemotherapy
Adjuvant
chemoradiation
Adjuvant
chemotherapy
Palliative
chemotherapy
Best supportive
care
if unfit for
treatment
Her-2 negative:
Platinum +
Fluoropyrimidine-
based doublet or
triplet regimen
HER-2 positive:
Trastuzumab
+ CF/CX
2
nd
line single
agent
chemo / trials if
adequate PS
Consider clinical
trials of novel
agents
Re-assess ?