UPPER GI ONCOLOGY · CONDITION GUIDE
Stomach Cancer
Gastric adenocarcinoma requiring surgical resection as the cornerstone of curative treatment — combined with perioperative chemotherapy and lymphadenectomy for optimal oncological outcomes.
ABOUT THIS CONDITION
What is Stomach Cancer?
Gastric cancer (stomach cancer) is the fifth most common cancer worldwide. Most are adenocarcinomas arising in the gastric antrum or body. Presenting symptoms are often non-specific in early disease, delaying diagnosis. Surgical resection — total or subtotal gastrectomy with D2 lymphadenectomy — remains the only curative treatment. Perioperative chemotherapy improves survival in resectable locally advanced disease. Dr. Tagore Mohan Grandhi performs laparoscopic and open gastrectomy for stomach cancer at Lux Hospitals, Hyderabad, as part of a multidisciplinary oncological team. The extent of gastric resection — subtotal or total — is determined by tumour location, while D2 lymphadenectomy ensures adequate lymph node harvest for accurate staging and oncological clearance.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- H. pylori infection causing chronic gastritis and mucosal atrophy
- Diet high in salt, smoked, and preserved foods
- Smoking — an independent risk factor
- Familial gastric cancer syndromes (CDH1 mutation, hereditary diffuse gastric cancer)
- Atrophic gastritis, intestinal metaplasia, and gastric polyps as pre-malignant conditions
- Previous gastrectomy increasing risk of remnant gastric cancer after 15–20 years
CLINICAL DETAILS
KeyFacts
Subtotal or total gastrectomy with D2 lymphadenectomy
Recommended for locally advanced (T3/T4 or node-positive) disease
Minimum 15 nodes required for accurate staging
Over 90% for stage I; 20–30% for stage III
Enhanced recovery; soft diet introduced progressively
Available at Lux Hospitals, Hitech City, Hyderabad
HOW WE TREAT IT
Treatment Approach
D2 Gastrectomy with Lymphadenectomy
D2 gastrectomy — removal of the stomach with a complete D2 lymph node dissection — is the recommended oncological standard for resectable gastric cancer. Dr. Grandhi performs D2 gastrectomy laparoscopically wherever feasible, achieving equivalent oncological results with smaller incisions, less blood loss, and faster recovery.
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Staging & MDT Planning
CT thorax, abdomen, and pelvis stages the disease. Staging laparoscopy excludes peritoneal disease before committing to resection. The MDT determines the need for perioperative chemotherapy and the extent of resection.
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Perioperative Chemotherapy (if indicated)
For locally advanced gastric cancer, 3 cycles of pre-operative chemotherapy (FLOT or CAPOX regimen) are administered before surgery, followed by post-operative chemotherapy after adequate recovery.
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Total or Subtotal Gastrectomy with D2 Lymphadenectomy
The stomach — totally or partially — is resected laparoscopically or open with a complete D2 lymph node dissection. Reconstruction is performed with Roux-en-Y esophagojejunostomy (total) or gastrojejunostomy (subtotal).
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Nutritional Rehabilitation & Follow-up
A liquid diet is introduced progressively, advancing to soft solid food over 4–6 weeks. Vitamin B12 and iron supplementation are prescribed long-term. Surveillance CT and endoscopy monitor for recurrence.
AVAILABLE TREATMENTS
TreatmentOptions
Subtotal Gastrectomy
Resection of the distal two-thirds to three-quarters of the stomach with D2 lymphadenectomy for antral and body cancers distant from the cardia.
Total Gastrectomy
Resection of the entire stomach with D2 lymphadenectomy and Roux-en-Y esophagojejunal reconstruction for proximal gastric and cardia cancers.
Endoscopic Mucosal Resection (EMR)
Early superficial stomach lesions are removed endoscopically from the inner lining.
COMMON QUESTIONS
Frequently Asked Questions
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