Are all centers able to offer an adequate carcinological treatment for gastric carcinoma?

Dysphagia, hematemesis, pain, anorexia, and dyspepsia are among the most common presenting symptoms of gastric cancer. Thus, the patients are initially referred to the gastroenterologist for further evaluation. The diagnosis of GC is made via upper gastro-intestinal endoscopy and biopsies. The pathologist must evaluate the specimen with microscopic morphologic and immune-histochemical studies. As all the cancers are now re-classified in different molecular genomic sub-types, as described in the cancer genome atlas (TCGA), the pathologic reports are becoming more challenging. However, outside a clinical trial, the recommendations are to test for human epidermal growth factor receptor 2 (Her-2) and program death ligand 1 (PDL1) expressions.1,2