Distinct molecular subtypes of gastric cancer: from Laurén to molecular pathology
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Magdalena Cisło1, Agata Anna Filip2, George Johan Arnold Offerhaus3, Bogumiła Ciseł1, Karol Rawicz-Pruszyński1, Małgorzata Skierucha1,4 and Wojciech Piotr Polkowski1
1Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
2Department of Cancer Genetics and Cytogenetics Laboratory, Medical University of Lublin, Lublin, Poland
3Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
4Department of Human Anatomy, Medical University of Lublin, Lublin, Poland
Magdalena Cisło, email: [email protected]
Keywords: stomach neoplasm; pathology; molecular therapeutics; surgical oncology
Received: November 30, 2017 Accepted: February 27, 2018 Published: April 10, 2018
In Western countries the majority of gastric cancers (GC) are usually diagnosed in advanced stages reporting a 5-year survival rate of only 26%. The Laurén classification of GC was most widely used in clinical practice since it reflects GC morphology, epidemiology, tumor biology, clinical management and outcome. Despite the initial promise of individualizing antitumor treatment, the management of GC still remains relatively broad and general. Apart from clinical staging, molecular profiling enables targeting of the identified underlying alterations, rather than histology. In contrast to breast carcinoma, molecular classification of GC does not yet imply treatment modality. Molecular classifications of GC and their therapeutic implications are therefore extensively studied. The current proposed molecular divisions of GC come from three different parts of the world where different standard treatment modalities for advanced GC are recommended. Wider use of GC molecular subtyping may solve problems, such as susceptibility to novel systemic therapy regimens or selection of patients for aggressive surgery and targeted adjuvant/conversion therapy. In any case, the rapid entry of novel molecular targeted therapies into routine oncology practice clearly underscores the urgent need for clinicians to be aware of these new possibilities.
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