Despite the advances and research efforts over the last decade, the outcome for patients with gastric cancer remains poor, largely because many gastric cancers are diagnosed at a late stage. The relatively low incidence of the disease in the United States makes large-scale screening unfeasible. Efforts should be directed toward improving therapeutic strategies.
Large, comprehensive database efforts, such as those under way at M. D. Anderson, will help to better define the natural history of this disease and to generate new hypotheses for translational research. Gastric cancer is likely to include distinct subtypes, with different risk factors, patterns of spread, and underlying molecular biologic characteristics. As we enter the era of targeted therapy, it is very important for us to understand these differences.
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