Gastric cancer (GC) is responsible for 9% of
cancer deaths worldwide. Over 950,000 new cases are diagnosed each year, and about 90% of them are in advanced stage, requiring
chemotherapy. In Europe there has been research based on pre- and postoperative
chemotherapy treatment, using
5-fluorouracil,
epirubicin,
cisplatin,
capecitabine, and
docetaxel.
Chemotherapy significantly impairs the quality of life of patients; however, the final effects are not always satisfactory. There is scientific evidence that gastric mucus
tumors and signet ring cell
carcinomas have a pattern of specific signatures, that distinguish them from other
gastric cancer subtypes, and may be associated with a poor response to systematic treatment.
Signet ring cell carcinoma is less chemosensitive than others, and the increase in the percentage of signet ring cells correlates with resistance to
chemotherapy. Perioperative
chemotherapy in advanced signet ring cell
carcinomas is an independent factor of poor prognosis and survival, which is explained by the toxicity of
neoadjuvant treatment. Therefore, curative surgical resection enhanced by standardized
lymphadenectomy remains the recommended gold standard in GC
therapy. According to presented studies, early detection and aggressive treatments for this subtype of GC is a reasonable approach. This review paper is mostly addressed to physicians who are interested in updating to the state of the art concerning different subtypes of gastric
carcinoma.