CDH1 and gastric cancer: Thus, according to current guidelines, prophylactic total gastrectomy (PTG) should be strongly advised in asymptomatic carriers of CDH1 pathogenic mutations, since this is the only way to completely eradicate their risk of GC; furthermore, almost 100 % of performed gastrectomies revealed the presence of microscopic cancer foci The optimal timing for the surgery is under debate, although most procedures are performed between the ages of 20 and 30 years, and current guidelines advocate this (Monahan and Hopkins 2016, van der Post et al. 2015).