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Gastroesophagic junction cancer

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https://www.readbyqxmd.com/read/28448662/effect-of-neoadjuvant-chemotherapy-followed-by-surgical-resection-on-survival-in-patients-with-limited-metastatic-gastric-or-gastroesophageal-junction-cancer-the-aio-flot3-trial
#1
Salah-Eddin Al-Batran, Nils Homann, Claudia Pauligk, Gerald Illerhaus, Uwe M Martens, Jan Stoehlmacher, Harald Schmalenberg, Kim B Luley, Nicole Prasnikar, Matthias Egger, Stephan Probst, Helmut Messmann, Markus Moehler, Wolfgang Fischbach, Jörg T Hartmann, Frank Mayer, Heinz-Gert Höffkes, Michael Koenigsmann, Dirk Arnold, Thomas W Kraus, Kersten Grimm, Stefan Berkhoff, Stefan Post, Elke Jäger, Wolf Bechstein, Ulrich Ronellenfitsch, Stefan Mönig, Ralf D Hofheinz
Importance: Surgical resection has a potential benefit for patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction. Objective: To evaluate outcome in patients with limited metastatic disease who receive chemotherapy first and proceed to surgical resection. Design, Setting, and Participants: The AIO-FLOT3 (Arbeitsgemeinschaft Internistische Onkologie-fluorouracil, leucovorin, oxaliplatin, and docetaxel) trial is a prospective, phase 2 trial of 252 patients with resectable or metastatic gastric or gastroesophageal junction adenocarcinoma...
April 27, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28425657/different-time-trend-and-management-of-esophagogastric-junction-adenocarcinoma-in-three-asian-countries
#2
Waku Hatta, Daniel Tong, Yeong Yeh Lee, Shin Ichihara, Noriya Uedo, Takuji Gotoda
Esophagogastric junction (EGJ) adenocarcinoma has been on the increase in Western countries. However, in Asian countries, data on the incidence of EGJ adenocarcinoma are evidently lacking. In the present review, we focus on the current clinical situation of EGJ adenocarcinoma in three Asian countries: Japan, Hong Kong, and Malaysia. The incidence of EGJ adenocarcinoma has been reported to be gradually increasing in Malaysia and Japan, whereas it has stabilized in Hong Kong. However, the number of cases in these countries is comparatively low compared with Western countries...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28425653/endoscopic-gastric-mucosal-atrophy-distinguishes-the-characteristics-of-superficial-esophagogastric-junction-adenocarcinoma
#3
Noriya Uedo, Toshiyuki Yoshio, Shigetaka Yoshinaga, Manabu Takeuchi, Waku Hatta, Tomonori Yano, Tokuma Tanuma, Osamu Goto, Akiko Takahashi, Daniel Tong, Yeong Yeh Lee, Yoshiko Nakayama, Shin Ichihara, Takuji Gotoda
BACKGROUND AND AIM: Western studies have suggested two distinct etiologies of esophagogastric junction (EGJ) cancer: Helicobacter pylori-associated atrophic gastritis and non-atrophic gastric mucosa resembling esophageal adenocarcinoma. The present study investigated whether endoscopic gastric mucosal atrophy can distinguish between these two types of EGJ adenocarcinoma. METHODS: Data were collected from patients with Siewert type II, T1 EGJ adenocarcinoma who underwent endoscopic or surgical resection at eight Japanese institutions in 2010-2015...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28416743/the-urokinase-plasminogen-activation-system-in-gastroesophageal-cancer-a-systematic-review-and-meta-analysis
#4
Daniel Brungs, Julia Chen, Morteza Aghmesheh, Kara L Vine, Therese M Becker, Martin G Carolan, Marie Ranson
BACKGROUND: The urokinase plasminogen activation (uPA) system is a crucial pathway for tumour invasion and establishment of metastasis. Although there is good evidence that uPA system expression is a clinically relevant biomarker in some solid tumours, its role in gastroesophageal cancer is uncertain. RESULTS: We identified 22 studies encompassing 1966 patients which fulfilled the inclusion criteria. uPA, uPAR, or PAI-1 expression is significantly associated with high risk clinicopathological features...
April 4, 2017: Oncotarget
https://www.readbyqxmd.com/read/28415835/the-role-of-chemotherapy-in-unresectable-or-metastatic-adenocarcinoma-of-the-stomach-and-gastroesophageal-junction
#5
Mustafa Bozkurt, Fatemeh G Amlashi, Mariela Blum Murphy
Gastric cancer including gastro-esophageal junction adenocarcinomas are most challenging and deadly cancers of the gastrointestinal tract. Gastric cancer has a fatality-to-case ratio of 0.66, translating that nearly two thirds of newly diagnosed patients will have disseminated disease and in need of systemic therapy (1). Advanced gastric adenocarcinoma (AGC) is a heterogenous disease with differences in geographical distribution, histopathology, and molecular subtypes. Fluoropyrimidines (5-FU, S-1, and capecitabine), platinum compounds (cisplatin, oxaliplatin), taxanes (paclitaxel, docetaxel), and the topoisomerase inhibitory irinotecan are active drugs against AGC...
April 14, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28386965/perioperative-chemotherapy-versus-postoperative-chemoradiotherapy-in-patients-with-resectable-gastric-gastroesophageal-junction-adenocarcinomas-a-survival-analysis-of-5058-patients
#6
Timothy L Fitzgerald, Jimmy T Efird, Nelly Bellamy, Suzanne M Russo, Charulata Jindal, Catalina Mosquera, Elizabeth G Holliday, Tithi Biswas
BACKGROUND: Both perioperative chemotherapy (PECT) and postoperative chemoradiotherapy (POCRT) have a significant survival advantage over surgery alone for the treatment of patients with gastric cancer. However, to the best of our knowledge, these regimens have not been compared in a randomized clinical trial. The purpose of the current observational study was to compare overall survival among patients receiving PECT versus POCRT for the treatment of gastric/gastroesophageal junction (GEJ) adenocarcinomas...
April 6, 2017: Cancer
https://www.readbyqxmd.com/read/28384630/esophageal-cancer-new-insights-into-a-heterogenous-disease
#7
Sebastian Krug, Patrick Michl
BACKGROUND: Esophageal cancer represents a heterogeneous malignancy mostly diagnosed in advanced stages. Worldwide, squamous cell carcinomas (SCCs) continue to be the most prevalent subtype; however, in the Western countries, the incidence of adenocarcinomas is increasing and will exceed that of SCC in the near future. During the last decade, several landmark trials contributed to a better understanding of the disease and emphasized the importance of multimodal treatment protocols. SUMMARY: With the introduction of perioperative or neoadjuvant approaches, the survival of both subtypes of esophageal cancer has significantly improved...
April 7, 2017: Digestion
https://www.readbyqxmd.com/read/28349718/overview-of-different-available-chemotherapy-regimens-combined-with-radiotherapy-for-the-neoadjuvant-and-definitive-treatment-of-esophageal-cancer
#8
Gianluca Tomasello, Michele Ghidini, Sandro Barni, Rodolfo Passalacqua, Fausto Petrelli
Neoadjuvant chemoradiotherapy (CTRT) is the current standard of care for treatment of locally advanced cancer of the esophagus or gastroesophageal junction. Many efforts have been made over the last years to identify the best chemotherapy and radiotherapy combination regimen, but specific randomized trials addressing this issue are still lacking. Areas covered: A systematic review of the literature was performed searching in Pubmed all published studies of combinations CTRT regimens for operable or unresectable esophageal cancer to describe activity and toxicity...
March 28, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28337865/helicobacter-pylori-and-barrett%C3%A2-s-esophagus-a-protective-factor-or-a-real-cause
#9
G Tomasello, F Giordano, M Mazzola, R Jurjus, A Jurjus, P Damiani, S Nobile, F Carini, A Leone
Notwithstanding the definite aetiopathogenetic path of certain diseases, the relationship between Helicobacter pylori (H. pylori) and Barrett’s esophagus (BE), a condition that increases the risk for dysplasia and consequently adenocarcinoma of the distal esophagus and esophagogastric junction, remains uncertain. This paper reviews the current scientific literature with emphasis on the protective correlation between H. pylori infection and BE and demonstrates that a causal relationship has not been disproved with certainty...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28337363/epidemiologic-study-of-human-epidermal-growth-factor-receptor-2-expression-in-advanced-metastatic-gastric-cancer-an-assessment-of-human-epidermal-growth-factor-receptor-2-status-in-tumor-tissue-samples-of-gastric-and-gastro-esophageal-junction-cancer
#10
Kyung Won Seo, Taeyong Jeon, Sewon Kim, Sung Soo Kim, Kwanghee Kim, Byoung-Jo Suh, Sunhwi Hwang, SeongHee Choi, Seungwan Ryu, Jae Seok Min, Young-Joon Lee, Ye Seob Jee, Hyeondong Chae, Doo Hyun Yang, Sang Ho Lee
PURPOSE: The Trastuzumab for gastric cancer (GC) trial identified human epidermal growth factor receptor 2 (HER2) as a predictor of successful treatment with trastuzumab (HER2 receptor targeting agent) among patients with advanced/metastatic GC. To date, the prevalence of HER2 overexpression in the Korean population is unknown. The present study aimed to assess the incidence of HER2 positivity among GC and gastroesophageal (GE) junction cancer samples and the relationship between HER2 overexpression and clinicopathological characteristics in Korean patients...
March 2017: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/28306358/the-genetics-of-gastroesophageal-adenocarcinoma-and-the-use-of-circulating-cell-free-dna-for-disease-detection-and-monitoring
#11
Mark R Openshaw, Catherine J Richards, David S Guttery, Jacqueline A Shaw, Anne L Thomas
Gastroesophageal adenocarcinoma (GOA) is a frequently occurring cancer worldwide with a poor clinical outcome. Adenocarcinomas of the esophagus and gastroesophageal junction have shown a recent increase in frequency, therefore there is need to increase our understanding of GOA in order to improve our ability to detect, monitor and treat the disease. Areas covered: The authors discuss the current classification of GOA in the context of recent changes in incidence. The authors also discuss developments in the understanding of disease biology and recent discoveries from whole genome and whole exome sequencing, and studies in immunotherapy...
March 30, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28299508/prognostic-role-of-primary-tumor-location-in-non-metastatic-gastric-cancer-a-systematic-review-and-meta-analysis-of-50-studies
#12
REVIEW
Fausto Petrelli, Michele Ghidini, Sandro Barni, Francesca Steccanella, Giovanni Sgroi, Rodolfo Passalacqua, Gianluca Tomasello
INTRODUCTION: The incidence of gastric cancer (GC) arising in the upper third of the stomach, including the cardia or gastroesophageal junction (GEJ), has increased in the last decades due to established etiological risk factors such as diet, obesity, and gastroesophageal reflux. We conducted a systematic review and meta-analysis to determine the prognostic role of site of origin in patients with proximal versus distal GC. MATERIAL AND METHODS: We conducted a search of the PubMed, Cochrane Library, SCOPUS, Web of Science, EMBASE, Google Scholar, LILACS, and CINAHL databases from inception to September 2016...
March 15, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28279470/novel-targeted-therapies-for-esophagogastric-cancer
#13
REVIEW
Steven B Maron, Daniel V T Catenacci
Gastroesophageal cancer (GEC) remains a major cause of cancer-related mortality worldwide. Although the incidence of distal gastric adenocarcinoma (GC) is declining in the United States, proximal esophagogastric junction adenocarcinoma (EGJ) is increasing in incidence. GEC, including GC and EGJ, is treated uniformly in the metastatic setting. Overall survival in the metastatic setting remains poor. Molecular characterization of GEC has identified mutations and copy number variations, along with other oncogenes, biomarkers, and immuno-oncologic checkpoints that may serve as actionable therapeutic targets...
April 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28279467/controversies-and-consensus-in-preoperative-therapy-of-esophageal-and-gastroesophageal-junction-cancers
#14
REVIEW
Geoffrey Y Ku
This review summarizes established adjuvant approaches for locally advanced esophageal cancer (including preoperative, perioperative, or postoperative approaches, which include chemotherapy alone or chemoradiation). It also discusses areas of uncertainty and therapeutic equipoise.
April 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28279466/current-progress-in-the-adjuvant-treatment-of-gastric-cancer
#15
REVIEW
David H Ilson
Staging of locally advanced gastric cancer includes imaging with computed tomography scan and laparoscopic assessment to rule out peritoneal disease or positive peritoneal washings. Preoperative and postoperative chemotherapy improves survival compared with surgery alone. After primary D2 resection, adjuvant chemotherapy with a fluorinated pyrimidine with or without a platinum agent improves survival. Inclusion of postoperative radiation therapy appears required in combination with chemotherapy in patients with less than a D1-D2 resection...
April 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28251375/adjuvant-therapy-for-locally-advanced-gastric-cancer
#16
REVIEW
Toru Aoyama, Takaki Yoshikawa
D2 gastrectomy is now the globally accepted surgical standard for locally advanced gastric cancer. However, since 2000, different evidence has emerged regarding the efficacy of adjuvant chemoradiation, perioperative adjuvant chemotherapy, and postoperative chemotherapy for locally advanced gastric cancer. This review summarizes the background, current status, and future perspectives of adjuvant therapy for locally advanced gastric cancer. The Intergroup 0116 study was the first to show the significant overall survival benefits of adjuvant (chemoradiation) therapy for gastric cancer...
March 1, 2017: Surgery Today
https://www.readbyqxmd.com/read/28251360/role-of-3d-in-minimally-invasive-esophagectomy
#17
Alexandros Charalabopoulos, Bruno Lorenzi, Ali Kordzadeh, Cheuk-Bong Tang, Sritharan Kadirkamanathan, Naga Venkatesh Jayanthi
PURPOSE: Two-stage minimally invasive esophagectomy (MIE) has gained popularity in the surgical treatment of esophageal cancer. MIE's limitation is embedded in the construction of intrathoracic anastomosis. Various anastomotic techniques have been reported; however, the mechanical one remains the most commonly adopted. This pilot study aims to describe an efficient, safe, and reproducible way of performing a hand-sewn intrathoracic esophagogastric anastomosis in conjunction with short-term results using 2D and 3D thoracoscopic approaches...
March 1, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28209106/gastroesophageal-junction-and-gastroesophageal-junction-carcinoma%C3%A2-a-short-update
#18
REVIEW
K A Ekmektzoglou, P Apostolopoulos, G Samelis, G Alexandrakis
Cancer of the gastroesophageal junction (GEJ), although rare, is now considered a separate entity with a distinct pathophysiological and molecular profile. Although much progress has been made over the past decades in delineating the multiple environmental and genetic pathways involved GEJ carcinoma, the exact molecular mechanisms underlying disease initiation and progression are still poorly understood. This is of paramount importance for the treating physician as the disease bears a poor therapeutic response...
September 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/28187044/minimally-invasive-versus-open-esophageal-resection-three-year-follow-up-of-the-previously-reported-randomized-controlled-trial-the-time-trial
#19
Jennifer Straatman, Nicole van der Wielen, Miguel A Cuesta, Freek Daams, Josep Roig Garcia, Luigi Bonavina, Camiel Rosman, Mark I van Berge Henegouwen, Suzanne S Gisbertz, Donald L van der Peet
OBJECTIVE: The aim of this study was to investigate 3-year survival following a randomized controlled trial comparing minimally invasive with open esophagectomy in patients with esophageal cancer. BACKGROUND: Research on minimally invasive esophagectomy (MIE) has shown faster postoperative recovery and a marked decrease in pulmonary complications. Debate is ongoing as to whether the procedure is equivalent to open resection regarding oncologic outcomes. The study is a follow-up study of the TIME-trial (traditional invasive vs minimally invasive esophagectomy, a multicenter, randomized trial)...
February 9, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28165839/targeting-vegfr-2-in-metastatic-gastric-cancer-results-from-a-literature-based-meta-analysis
#20
Giandomenico Roviello, Karol Polom, Franco Roviello, Daniele Marrelli, Andrea Giovanni Multari, Giovanni Paganini, Chiara Pacifico, Daniele Generali
Angiogenesis is a key process in cancer development. We performed a meta-analysis to assess the efficacy and safety of the novel VEGFR-2 inhibitors in patients with metastatic gastric and gastroesophageal junction cancer. A literature-based meta-analysis of randomized controlled trials (RCTs) was undertaken. The primary outcome was the overall survival. The pooled analysis from RCTs on anti-VEGFR-2 inhibitors revealed a significant increase in overall survival (hazard ratio for death: 0.69, 95% confidence interval: 0...
March 16, 2017: Cancer Investigation
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