Gastric cancer is the fourth most common cancer in the world with an annual incidence of approximately one million 1. In the UK, there are an estimated 7,700 new diagnoses and 5,200 deaths from the disease each year 2. Over the past two decades there has been a change in the anatomical subsite distribution of gastric cancer, with a trend for tumours to develop more in the proximal stomach, especially around the gastric cardiac area rather than the distal part of the stomach 3. It is thought that the lower oesophageal tumours may also be associated with an increasing incidence of gastro-oesophageal reflux disease 4. In spite of a declining incidence of the distal stomach cancer in the Western countries over the past decades, the incidence of adenocarcinoma of the lower esophagus and the gastroesophageal junction has dramatically increased in the world 5. Early-stage gastric and gastroesophageal cancers are curable with surgical treatment alone, with a 5-year overall survival rate of 90%. However, the majority of gastric and gastroesophageal cancer patients are diagnosed with advanced diseases (stages III or IV) 6. Despite advances in cancer management, gastric cancer continues to remain a challenging disease to
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