• Lorenzo Fornaro, Andrea Spallanzani, Ferdinando de Vita, Domenico D'Ugo, Alfredo Falcone, Laura Lorenzon, Giuseppe Tirino, Stefano Cascinu, and GAIN (GAstric Cancer Italian Network).
• Department of Translational Medicine, Division of Medical Oncology, AOU Pisana, 56126 Pisa, Italy.
• Cancers (Basel). 2021 Mar 15; 13 (6).

BackgroundManagement of gastric and gastroesophageal junction (GEJ) adenocarcinoma remains challenging, because of the heterogeneity in tumor biology within the upper gastrointestinal tract. Daily clinical practice is full of grey areas regarding the complexity of diagnostic, staging, and therapeutic procedures. The aim of this paper is to provide a guide for clinicians facing challenging situations in routine practice, taking a multidisciplinary consensus approach based on available literature.MethodsThe GAIN (GAstric cancer Italian Network) group was established with the aims of reviewing literature evidence, discussing key issues in prevention, diagnosis, and management of gastric and GEJ adenocarcinoma, and offering a summary of statements. A Delphi consensus method was used to obtain opinions from the expert panel of specialists.ResultsForty-nine clinical questions were identified in six areas of interest: role of multidisciplinary team; risk factors; diagnosis; management of early gastric cancer and multimodal approach to localized gastric cancer; treatment of elderly patients with locally advanced resectable disease; and treatment of locally advanced and metastatic cancer.ConclusionsThe statements presented may guide clinicians in practical management of this disease.

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