The survivability of stomach cancer in Italy is generally challenging, with outcomes heavily dependent on the stage at diagnosis and the effectiveness of treatment strategies. Stomach cancer, also known as gastric cancer, often presents late because early symptoms are vague or absent, leading to diagnosis at advanced stages when curative options are limited. In Italy, as in much of Europe, the overall five-year survival rate for stomach cancer remains below 50%, reflecting the aggressive nature of the disease and the difficulty in early detection.
Several factors influence survivability. Early-stage detection significantly improves prognosis, but unfortunately, many patients are diagnosed only after the cancer has progressed. For patients with low-grade gastric intraepithelial neoplasia (LGIN), a precancerous condition, studies show that a majority can experience lesion reversal with appropriate monitoring and treatment, but a small percentage progress to adenocarcinoma, the most common form of stomach cancer. The progression risk varies with the severity of dysplasia, with moderate dysplasia patients showing a higher chance of developing cancer compared to those with mild dysplasia.
Treatment in Italy follows European standards, which emphasize perioperative chemotherapy combined with surgery for curative intent. Surgery aims to remove the tumor entirely, but the success of this depends on tumor resectability, which can be complicated by tumor location and spread. Staging laparoscopy is used selectively to assess whether the tumor can be surgically removed, especially when imaging suggests possible infiltration into surrounding tissues. However, about 10% of patients develop metastases even after negative staging laparoscopy, which complicates treatment and worsens prognosis.
Nutritional status also plays a critical role in survivability. The Prognostic Nutritional Index (PNI), which assesses a patient’s nutritional and immune status, has been identified as an important predictor of long-term survival and postoperative complications in gastric cancer patients. Maintaining good nutrition before and after surgery can improve outcomes and reduce the risk of complications.
Despite advances in chemotherapy, its effectiveness for advanced gastric cancer remains modest, with median overall survival around eight months for patients with metastatic disease. This highlights the importance of early detection and comprehensive treatment planning. Italy’s healthcare system provides access to multidisciplinary care, including surgery, chemotherapy, and supportive care, which can improve survival rates compared to regions with less integrated care.
In summary, the survivability of stomach cancer in Italy is influenced by early diagnosis, tumor characteristics, treatment approaches including surgery and chemotherapy, and patient factors such as nutritional status. While five-year survival rates are improving with advances in medical care, stomach cancer remains a serious disease with significant mortality, underscoring the need for continued efforts in early detection, effective treatment, and supportive care.
