Primary gastric squamous cell carcinoma: challenges in treatment strategy

Diagnosis requires systematically excluding other primary squamous cell carcinoma sites (oesophagus, lung, head and neck) before confirming primary gastric squamous cell carcinoma (GSCC).Radical resection (R0) combined with aggressive adjuvant chemotherapy is the optimal treatment strategy, offering the best survival chance even in advanced disease (pT4bN3aM0, LVI+/PNI+).Treatment must be individualised due to a lack of standardised protocols: for this extremely rare malignancy, the decision between upfront surgery versus neoadjuvant chemotherapy should be based on tumour resect ability, biological characteristics and multidisciplinary tumour board discussion.