Assoc. Prof.Cengiz Dibekoğlu, MD

General Surgeon

Laparoscopic · Robotic · Oncologic Surgery

Conditions/Oncologic surgery

Gastric oncology

Stomach (Gastric) Cancer

Staging, biomarkers, perioperative therapy, and gastrectomy

HER2, PD-L1, CLDN18.2, and MSI/MMR are not interchangeable labels — timing and meaning differ by stage.

Gastric cancer care combines accurate staging — including staging laparoscopy and peritoneal cytology when indicated — with perioperative chemotherapy for many locally advanced tumors and gastrectomy with appropriate lymphadenectomy. Early disease may present with vague dyspepsia; progressive symptoms deserve endoscopy rather than prolonged empiric treatment. Biomarkers guide systemic therapy especially in advanced disease: HER2, PD-L1, and CLDN18.2 mainly shape metastatic drug choice, while MSI/MMR can matter earlier. Minimally invasive gastrectomy is considered when oncologic standards can be met safely.

Stomach (Gastric) Cancer · educational illustration

Figure labels (English)

  • Esophagus
  • Stomach
  • Duodenum

Educational figures

Tap a figure to enlarge. These English illustrations mirror the Turkish hub gallery for this condition.

  • Diagnosis
  • Treatment
  • Operations
  • Robotic

  • Perioperative pathway

    Neoadjuvant then surgery then adjuvant when indicated.

  • Biomarkers by stage

    HER2 / PD-L1 / CLDN18.2 mainly shape advanced systemic choices.

  • MSI/MMR

    Separate clinical meaning, including earlier settings.

  • Minimally invasive options

    Laparoscopic / robotic gastrectomy in selected cases.

Key points for patients

  • How biomarkers affect treatment
    Tap for details · key note inside

    HER2, PD-L1 CPS, and CLDN18.2 mainly influence advanced/metastatic drug choice. MSI/MMR may matter in localized disease as well. Not every marker is mandatory at every stage.

    • MSI/MMR → stage-dependent meaning
    • HER2 / PD-L1 / CLDN18.2 → mainly advanced disease
    • Timing is set in tumor board
  • Staging before locking sequence
    Tap for details

    CT staging, endoscopy, and — when indicated — staging laparoscopy with cytology prevent operating into unresectable peritoneal disease.

  • Surgery types
    Tap for details

    Subtotal versus total gastrectomy depends on tumor location and oncologic margins. Lymphadenectomy extent follows oncologic standards, not incision size.

  • Nutrition is part of treatment
    Tap for details

    Prehabilitation, feeding routes, and vitamin supplementation after gastrectomy are planned with the resection — not left as an afterthought.

  • When major resection is not offered
    Tap for details · key note inside

    Unresectable spread or performance status that cannot tolerate major surgery changes the goal toward systemic therapy and symptom control — stated honestly.

Patient journey

In this hub — follow the pathway step by step. Full Turkish illustrated pages remain linked from each chapter.

Oncologic surgery4 chapters

Appointment / info

Pathology with biomarker reports, endoscopy notes, and staging imaging accelerate an honest perioperative plan.

+90 542 725 50 70WhatsAppTumor boardFull Turkish hub →

Educational information only; not a substitute for clinical evaluation.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · English patient-education hub.

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