Germline Testing, Surgical Planning, and Multidisciplinary Follow up in Younger Patients With Gastric Cancer

This segment reviews how germline testing, family history, and multidisciplinary support influence surgical decision making for younger individuals with gastric cancer. The panel discusses why age under sixty often prompts germline evaluation, noting that findings such as CDH1 may alter the recommended extent of gastrectomy. The conversation emphasizes the importance of collecting a thorough family history and aligning surgical planning with genetic risk, including when to consider subtotal rather than total gastrectomy. The group also addresses variations in access to testing across community practices and the broader movement toward universal germline testing in gastrointestinal cancers. The panel reflects on DFLOT in the context of these cases and highlights the need for coordinated care among surgeons, oncologists, genetic counselors, nutrition teams, and nurse navigators. They conclude by noting the growing momentum in upper gastrointestinal cancer research and the expectation that future studies will further evolve perioperative strategies.