Gastric cancer is a complex and enigmatic disorder noted for marked global variations in etiology, incidence, natural course, and management. Many factors likely lead to and discriminate among biologically and clinically relevant gastric cancer subsets: antecedent tumorigenic conditions (Helicobacter pylori gastritis,1CDH1 mutation,2 and other chronic gastric disorders), location of the primary tumor (proximal or distal), subtypes of adenocarcinoma (diffuse, intestinal, or mixed),3 ethnicity of the afflicted population (differing levels of susceptibility and aggressiveness of the tumors), and a predictive biomarker (ERBB2). In essence, gastric cancer is a heterogeneous condition that represents several diseases.
Shah MA, Ajani JA. Gastric Cancer—An Enigmatic and Heterogeneous Disease. JAMA. 2010;303(17):1753–1754. doi:10.1001/jama.2010.553
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