Los Angeles-Area Stomach and Esophageal Cancer Care

Los Angeles has a diverse demographic, contributing to a higher incidence rate of stomach cancer than the national average. Meanwhile, there are limited care options available, as many hospitals in California perform only three or fewer esophageal or stomach cancer surgeries each year.

City of Hope® Cancer Center Duarte stands out as one of the top five high-volume centers for stomach and esophageal cancer surgeries in California. With our expertise in performing complex surgical procedures and offering coordinated care, we are the superior choice for treating stomach and esophageal cancer.

At City of Hope, your care is led by our highly experienced surgical and thoracic oncologists. Our team collaborates closely with you and your referring physician to develop a personalized treatment plan for stomach or esophageal cancer. This strategy ensures that the timing, extent and approach of your surgery are tailored specifically to your needs.

Our multidisciplinary team combines innovative surgical techniques, precision oncology and the latest cancer care strategies, leading to optimal outcomes for stomach and esophageal cancers and diseases affecting the gastroesophageal junction.

Additionally, when you come to City of Hope for treatment, you have access to our leading-edge investigational therapies and surgical approaches. Enrolling more than 730 clinical trials annually, our faculty members are leaders in translational research and committed to expediting the most promising treatments to their patients.

What Sets Our L.A.-Area Stomach and Esophageal Cancer Program Apart?

A Pioneer in Minimally Invasive Robotic Surgery

City of Hope sets itself apart from other hospitals that lack the expertise to perform as many surgical procedures, especially minimally invasive, laparoscopic and robotic surgery. This approach significantly improves patient outcomes compared to traditional open surgery. In fact, we perform more than 75% of our complex gastrectomies (total and subtotal), two-field esophagogastrectomies, esophagectomies and associated procedures using robotic-assisted surgery.

Some of our specialized services include:

• Minimally invasive robotic approaches for early and advanced gastric and esophageal adenocarcinomas
• Robotic-assisted gastric and esophageal resections for treating complex upper gastrointestinal cancers
• For locally advanced stomach cancer, we have extensive experience in performing the National Comprehensive Cancer Network-recommended D2 lymphadenectomy
• Robotic en-bloc multivisceral resection, which may include the stomach, distal pancreas and spleen as needed for locally advanced gastric and gastroesophageal junction tumors

Leader in Peritoneal-Directed Chemotherapy

City of Hope is one of the few centers that offer hyperthermic intraperitoneal chemotherapy (HIPEC) in combination with minimally invasive surgery. Additionally, we perform the highest volume of HIPEC procedures among medical centers in Los Angeles County.

HIPEC provides targeted treatment for advanced cancers that have spread throughout the peritoneum, where there are fewer blood vessels to deliver traditional intravenous chemotherapy. This technique allows us to administer higher concentrations of the drug while minimizing side effects, as the chemotherapy is confined to the peritoneal cavity.

Genetic Testing and Established Prophylactic Gastrectomy Program for High-Risk Individuals

City of Hope offers multidisciplinary cancer risk assessment and robotic-assisted gastrectomy for high-risk individuals, which is a service not offered by most hospitals. Our patients and their family members can access comprehensive germline testing regardless of medical or family history.

Advanced molecular profiling provides vital information for determining treatment strategies, e.g., identifying a tumor's specific biology, and uncovering hereditary or familial diseases like Lynch syndrome. For instance, individuals with pathogenic, highly penetrant CDH1 and CTNNA gene mutations are at higher risk of developing hereditary diffuse gastric cancer. Since there are over a hundred CDH1 variants with known and unknown risks of stomach cancer development, we can recommend and provide comprehensive genetic counseling, surveillance endoscopy and prophylactic surgery. We also analyze suitable tumor samples using ultra-comprehensive, whole-exome and whole-transcriptome tumor sequencing, including a best-in-class test for somatic mutations.

Access to Investigational Treatments in the Los Angeles Area

Our physicians use innovative approaches that are regional therapy designed to control peritoneal disease by using concentrated, higher doses of chemotherapy, to minimize the side effects of targeting tumors that are otherwise resistant to systemic therapies, such as:

• A single-port (single-incision) robotic system, approved for use in urologic and otolaryngologic procedures and utilized in abdominal surgeries.
• Patients with gastric adenocarcinoma with metastases to the peritoneum may be eligible for laparoscopic hyperthermic intraperitoneal chemotherapy or a study investigating pressurized intraperitoneal aerosol chemotherapy (PIPAC).

“Our team is dedicated to bringing the best of surgical innovation and medical science for the cure and care of patients with gastric and esophageal cancers. We are committed to ensuring that each patient receives a personalized treatment strategy with special attention given to the timing, extent and type of surgical approach, with preference for minimally invasive surgery.“

Yanghee Woo, M.D., associate professor and director, Gastroenterology Program

“What really makes City of Hope unique is our holistic, patient-centered approach. We really try to listen to the patient and understand what are their goals, what do they want to achieve and what is important to them?"

Jae Kim, M.D., chief and associate professor, Division of Thoracic Surgery