Topic: Multidisciplinary Approaches in Gastric Cancer

Gastric cancer is a complex disease whose management poses significant challenges, requiring strategies that extend beyond traditional single-specialty approaches. The Multidisciplinary Team (MDT) model has emerged as the gold standard in modern gastric cancer care, integrating expertise from surgery, medical oncology, radiation oncology, pathology, radiology, gastroenterology, and nutritional support to develop highly personalized treatment plans.

At the core of the MDT approach is collaboration and communication. During regular MDT meetings, experts collectively review each patient's case, considering tumor stage, pathological type, molecular markers (e.g., HER2 and MSI status), overall health, and personal preferences. Guided by the latest clinical evidence and consensus guidelines, the team evaluates the benefits and risks of various treatment modalities—including surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy—to determine the optimal sequence and combination. This may involve neoadjuvant therapy to reduce tumor size and improve surgical outcomes or adjuvant therapy to minimize recurrence risk.

This comprehensive, multidisciplinary strategy ensures that treatment decisions are holistic, forward-looking, and not limited to a single perspective. The MDT model enhances treatment precision and efficacy, enhances quality of life, and, through standardized collaborative processes, offers patients the best chance of survival. It embodies the principles of modern, patient-centered oncology.

This Special Issue aims to compile cutting-edge research and comprehensive reviews that highlight the pivotal role of MDTs across the gastric cancer care continuum—from neoadjuvant therapy to the management of elderly/comorbid patients. It also addresses specific topics such as molecular subtyping and adjuvant therapy controversies in gastrointestinal stromal tumors (GISTs), surgical debates over mesenteric defect closure to prevent post-gastrectomy internal hernias, and the integration of artificial intelligence and big data to enhance patient-centered decision making.

Potential Topics:

1. GIST Diagnosis and Treatment
● Molecular subtypes of GISTbased on KIT/PDGFRA exon mutations and their prognostic implications;
● Necessity of adjuvant therapyfor low-risk GIST;
● Management ofwild-type GIST: Is adjuvant therapy required?

2. Outcome Evaluation and Integration of Advancements
● Impact of MDTson Long-Term Survival and Quality of Life in Locally Advanced Gastric Cancer;
● Prospects for Artificial Intelligence and Big Data in MDT-based Decision Support.

3. Specific Stages and Special Populations
● Role of MDTs duringNeoadjuvant Therapy and Criteria for Efficacy Evaluation;
● MDT Management of Older or Comorbid Patients: Personalized Strategiesfor Vulnerable Populations.

4. Patient Involvement and Model Comparison
● Patient Participation in Shared DecisionMaking;
● ComparingEastern and Western MDT Models: Culture, Healthcare, and Clinical Practice Differences.

5. Intra-abdominal Hernia after Gastric Cancer Surgery
● Updates oninternal hernia after gastrectomy: Should mesenteric defects be closed?
● Risk Factors for Intra-abdominal Hernia Post-Gastric Cancer Surgery;
● Effect of Peterson's gap closure on internal hernia incidence.

6. Gastric Cancer Metastasis and MDT-based Management
● Molecular Mechanisms of Gastric Cancer Metastasis;
● Management of peritoneal, liver, and other distant metastases;
● Translational and Precision Medicine Approaches;
● Clinical Trials and Future Directions.

Multidisciplinary approaches, outcome evaluation, neoadjuvant therapy, model comparison, GIST, intra-abdominal hernia