Gastric cancer surveillance

Gastric cancer is the third leading cause of cancer mortality and the fifth for incidence worldwide. High-definition endoscopy with virtual chromoendoscopy allows to diagnose early stages of gastric cancers that can be removed by endoscopic resection. For advanced gastric cancers, surgery with or without chemotherapy may be necessary. Surveillance after gastric cancer treatment depends on the staging of the lesion and on the treatment. Aiming at detecting metachronous or local recurrence, endoscopic surveillance is necessary after endoscopic treatment or subtotal gastrectomy has been performed, whereas CT imaging is needed for distant metastasis according to baseline staging. After total gastrectomy, nutritional deficiencies evaluation and periodic CT for early detection of recurrence are essential.