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Clinical features, diagnosis, and staging of gastric cancer

Paul F Mansfield, MD, FACS
Section Editor
Kenneth K Tanabe, MD
Deputy Editors
Diane MF Savarese, MD
Shilpa Grover, MD, MPH


Most patients with gastric cancer in the United States are symptomatic and already have advanced incurable disease at the time of presentation. At diagnosis, approximately 50 percent have disease that extends beyond locoregional confines, and only one-half of those who appear to have locoregional tumor involvement can undergo a potentially curative resection. Surgically curable early gastric cancers are usually asymptomatic and only infrequently detected outside the realm of a screening program. Screening is not widely performed, except in countries which have a very high incidence, such as Japan, Venezuela, and Chile. (See "Gastric cancer screening".)

The common presenting symptoms and diagnostic approaches to gastric cancer will be reviewed here. Epidemiology, issues related to screening for high-risk patients, and the treatment of gastric cancer are discussed separately. (See "Epidemiology of gastric cancer" and "Gastric cancer screening" and "Adjuvant and neoadjuvant treatment of gastric cancer" and "Surgical management of invasive gastric cancer" and "Systemic therapy for locally advanced unresectable and metastatic esophageal and gastric cancer".)


Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis (table 1) [1].

Weight loss usually results from insufficient caloric intake rather than increased catabolism and may be attributable to anorexia, nausea, abdominal pain, early satiety, and/or dysphagia.

When present, abdominal pain tends to be epigastric, vague and mild early in the disease but more severe and constant as the disease progresses.


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Literature review current through: Sep 2016. | This topic last updated: May 8, 2015.
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