Published online Sep 15, 2019. doi: 10.4251/wjgo.v11.i9.665
Peer-review started: February 26, 2019
First decision: May 24, 2019
Revised: May 29, 2019
Accepted: August 20, 2019
Article in press: August 21, 2019
Published online: September 15, 2019
Processing time: 201 Days and 1 Hours
Over the last two decades there has been a broad paradigm shift in our understanding of gastric cancer (GC) and its premalignant states from gross histological models to increasingly precise molecular descriptions. In this review we reflect upon the historic approaches to describing premalignant lesions and GC, highlight the current molecular landscape and how this could inform future risk assessment prevention strategies.
Core tip: Despite recent advances in our understanding of the molecular and cellular events involved in gastric cancer, little is known about how gastric premalignant lesions actually lead to this usually lethal disease (5 years survival about 20% in most Western countries). It is still not clear whether some or all of these lesions are directly involved in the process of gastric carcinogenesis or whether they are simply bystanders. In this review, we attempt to shed some light into how our current understanding of premalignant lesions may be used to improve patient stratification and lead to better overall patient survival rates.