Delay in initiation adjuvant S-1 monotherapy for gastric cancer: important prognostic factor

According to the data of the GLOBOCAN cancer observatory of the World Health Organization (WHO) (1) the incidence of gastric tumours in 2018 worldwide was evaluated on 1,033,701 people [1006270–1061880] that means about 5.72% of all the tumours and a mortality evaluated on 782,685 people [738321–829715] making the gastric tumour at the third position as cause of death related to cancer just after lungs and Colorectal tumours. Due to the demographic change, even if we expect a relative decrease of gastric cancer in the western world, the WHO estimates an increase all over the world from 2018 to 2040 of the incidences of this tumour of 70.1% with an expected incidence on 2040 of 1,758,810 peoples (2). Worldwide the incidence of gastric tumour is higher in eastern counties (3) especially Mongolia where the age standardized rate (ASR) is up to 25:100,000, Bhutan (ASR: 18.9:100,000), China (ASR: 17.5:100,000). A well-known theory asset that this distribution of the Upper GI neoplasms is mainly due to the habit in those regions to consume very hot food making a direct damage on the mucosa.