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Neoadjuvant and gastric cancer

Toshifumi Yamaguchi, Ken Kato, Kengo Nagashima, Satoru Iwasa, Yoshitaka Honma, Atsuo Takashima, Tetsuya Hamaguchi, Yoshinori Ito, Jun Itami, Narikazu Boku, Kazuhide Higuchi
BACKGROUND: While the standard treatment for stage II-III (non-T4) esophageal squamous cell carcinoma (ESCC) is neoadjuvant therapy followed by esophagectomy, definitive chemoradiation therapy (dCRT) is an option to treat ESCC patients who reject or may not tolerate surgical treatment. Second primary malignancy (SPM) is a problem for long-term survivors after achieving complete response (CR) by dCRT. METHODS: The source of the subjects in this study was the patients with stage II/III (excluding T4 disease) ESCC (UICC6th) who underwent dCRT from 2000 to 2011 at the National Cancer Center Hospital, Japan...
March 8, 2018: International Journal of Clinical Oncology
Y H M Claassen, H H Hartgrink, J L Dikken, W O de Steur, J W van Sandick, N C T van Grieken, A Cats, A K Trip, E P M Jansen, W M Meershoek-Klein Kranenbarg, J P B M Braak, H Putter, M I van Berge Henegouwen, M Verheij, C J H van de Velde
BACKGROUND: In order to determine the optimal combination of perioperative chemotherapy and chemoradiotherapy for Western patients with advanced resectable gastric cancer, the international multicentre CRITICS trial (ChemoRadiotherapy after Induction chemotherapy In Cancer of the Stomach) was initiated. In this trial, patients with resectable gastric cancer were randomised before start of treatment between adjuvant chemotherapy or adjuvant chemoradiotherapy following neoadjuvant chemotherapy plus gastric cancer resection...
February 9, 2018: European Journal of Surgical Oncology
Q Zhao, Y Li, B Yu, P G Yang, L Q Fan, B B Tan, Y Tian, A B Yang
Objective: To investigate the effect of postoperative precision nutrition therapy on postoperative recovery (PR) of patients with advanced gastric cancer (AGC) after neoadjuvant chemotherapy (NC). Methods: 71 subjects were randomly divided into 2 groups. The 34 patients of research group were treated with postoperative precision nutrition treatment according to the indirect energy measurement method. The 31 patients of control group were treated with traditional postoperative nutrition treatment. All participants were measured for body mass index (BMI), NRS2002, PG-SGA and relevant laboratory test within the 1st day before surgery and 7th day after surgery...
February 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Michael Stahl, Annett Maderer, Florian Lordick, Andre L Mihaljevic, Stefan Kanzler, Thomas Hoehler, Peter Thuss-Patience, Stefan Mönig, Volker Kunzmann, Sebastian Schroll, Andreas Sandermann, Andrea Tannapfel, Hans-Joachim Meyer, Christoph Schuhmacher, Hansjochen Wilke, Markus Moehler
BACKGROUND: Perioperative chemotherapy significantly improves survival in patients with locally advanced oesophagogastric cancer (EGC). However, as approximately 60% of patients will die from their disease, new therapeutic agents such as molecular-targeted drugs are needed. PATIENTS AND METHODS: To evaluate the role of panitumumab with perioperative chemotherapy, previously untreated patients with locally advanced EGC received, in an open-label randomised phase II study (NEOPECX), standard epirubicin, cisplatin, capecitabine (ECX) chemotherapy with or without panitumumab...
March 1, 2018: European Journal of Cancer
Jiankun Hu, Weihan Zhang, Xinzu Chen
Neoadjuvant chemotherapy combined with radical gastrectomy is one of the most important parts of the multimodality therapy strategies for locally advanced gastric cancer. With the development of laparoscopic technique in recent decades, laparoscopic technique plays a more and more important role in the surgical treatment of gastric cancer. Neoadjuvant chemotherapy, as a part of comprehensive treatment of gastric cancer, has gained more and more clinical supports and been recommended for guidelines. With the development of laparoscopic technique and clinical evidence, laparoscopic operation for advanced gastric cancer has been applied more and more widely...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Jian Zhao, Gang Wang, Zhi-Wei Jiang, Chuan-Wei Jiang, Jiang Liu, Can-Can Xia, Jie-Shou Li
Background: Most studies on enhanced recovery after surgery (ERAS) for gastric cancer exclude patients who received neoadjuvant chemotherapy. Here, we aimed to evaluate whether patients who received neoadjuvant chemotherapy can be enrolled into the ERAS program for locally advanced gastric cancer. Methods: From April 2015 to July 2017, 114 patients who received neoadjuvant chemotherapy for locally advanced gastric cancer were randomized into ERAS and standard care (SC) groups...
February 20, 2018: Chinese Medical Journal
M G Schouwenburg, L A D Busweiler, N Beck, D Henneman, S Amodio, M I van Berge Henegouwen, A Cats, R van Hillegersberg, J W van Sandick, B P L Wijnhoven, M W J Wouters, G A P Nieuwenhuijzen
BACKGROUND: Dutch national guidelines on the diagnosis and treatment of gastric cancer recommend the use of perioperative chemotherapy in patients with resectable gastric cancer. However, adjuvant chemotherapy is often not administered. The aim of this study was to evaluate hospital variation on the probability to receive adjuvant chemotherapy and to identify associated factors with special attention to postoperative complications. METHODS: All patients who received neoadjuvant chemotherapy and underwent an elective surgical resection for stage IB-IVa (M0) gastric adenocarcinoma between 2011 and 2015 were identified from a national database (Dutch Upper GI Cancer Audit)...
January 12, 2018: European Journal of Surgical Oncology
Federico Coccolini, Matteo Nardi, Giulia Montori, Marco Ceresoli, Andrea Celotti, Stefano Cascinu, Paola Fugazzola, Matteo Tomasoni, Olivier Glehen, Fausto Catena, Yutaka Yonemura, Luca Ansaloni
INTRODUCTION: Even in after curative surgery and adequate linfoadenectomy the survival of advanced gastric cancer (AGC) remains poor. At present some data have been published on the effects of NACT and perioperative chemotherapy on AGC and Esophago-gastric cancer (EGC) but not definitive ones. The present meta-analysis aims to evaluate the effects of neoadjuvant chemotherapy (NACT) on the AGC and EGC. MATERIAL AND METHODS: A systematic review with meta-analysis of randomized controlled trials (RCTs) of NACT + surgery vs...
January 27, 2018: International Journal of Surgery
S T Kim, K C Banks, E Pectasides, S Y Kim, K Kim, R B Lanman, A Talasaz, J An, M G Choi, J H Lee, T S Sohn, J M Bae, S Kim, S H Park, J O Park, Y S Park, H Y Lim, N K D Kim, W Park, H Lee, A J Bass, K Kim, W K Kang, J Lee
Background: To identify predictive markers for responders in lapatinib-treated patients and to demonstrate molecular changes during lapatinib treatment via cell-free genomics. Patients and Methods: We prospectively evaluated the efficacy of combining lapatinib with capecitabine and oxaliplatin as first line neoadjuvant therapy in patients with previously untreated, HER2-overexpressing advanced gastric cancer (AGC). A parallel biomarker study was conducted by simultaneously performing immunohistochemistry (IHC) and next-generation sequencing with tumor and blood samples...
February 2, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Shanley Deal, Derek Nathan, Flavio G Rocha
Locally advanced pancreas cancer (LAPC) involving the celiac axis is typically considered unresectable and carries a poor prognosis. We present a case of a patient with LAPC who underwent a modified Appleby procedure for tumor clearance following neoadjuvant therapy. Technical aspects include diagnostic laparoscopy to exclude occult metastatic disease followed by complete mobilization of the pancreas and spleen, preservation of the left gastric artery, and resection and reconstruction of the common hepatic artery...
January 10, 2018: American Journal of Surgery
Takahiro Terashima, Shunji Kawamoto, Kouichi Maekawa, Norimitsu Kuroki
A 83-year-old female, with oppression in her chest, was subjected to type 2 advanced gasteric cancer in esophagogastric junction. Examinations revealed Stage III c of cT4, cN2, cM0. For adopting neoadjuvant chemotherapy, S-1 plus CDDP was not on the list, but S-1 plus oxaliplatin (SOX) was, because massive load of infusion along with the chemotherapy was not appropriate for the patient with low cardiac function. After 2 courses of SOX, the primary tumor as well as metastatic lymph nodes were shown with marked reduction in size by CT scan, which enabled total gastrectomy with D2 lymphadenectomy to be performed as a curative resection, leading to patient living with no recurrence more than 3 years...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Keiji Muramoto, Toru Miyake, Tomoharu Shimizu, Hiromichi Sonoda, Tomoyuki Ueki, Yoshitaka Terada, Haruki Mori, Hiromitsu Maehira, Katsushi Takebayashi, Sachiko Kaida, Hiroya Iida, Tsuyoshi Yamaguchi, Masaji Tani
The patient is male in his 60's. He underwent endoscopic examination for anemia, which was found during screening of high PSA value. Endoscopic examination revealed a gastric cancer and 3 colorectal cancers. Histological results from biopsy was HER2 positive poorly differentiated adenocarcinoma in gastric tumor and moderately differentiated adenocarcinoma in colorectal tumor. Chest CT showed a pulmonary nodule in the middle right lung. Histological diagnosis was TTF-1 positive adenocarcinoma, meaning primary lung cancer...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Atsushi Gakuhara, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Koji Tanaka, Tomoki Makino, Makoto Yamasaki, Kiyokazu Nakajima, Masaki Mori, Yuichiro Doki
A 71-year-old man was diagnosed with locally advanced gastric cancer(cT4b[Panc], N2, M0, cStage III C). He was treated with a triplet neoadjuvant chemotherapy regimen including docetaxel, oxaliplatin and S-1, followed by laparoscopic total gastrectomy with pancreatosplenectomy which achieved R0 resection. He had no pancreatic fistula, leakage and abscess and was transferred to other hospital on POD18 for rehabilitation. Adjuvant chemotherapy wish S-1was started on 7 weeks after surgery. Although multidisciplinary treatment such as perioperative chemotherapy and radical surgery is necessary, careful and precise interpretation of diagnostic image is mandatory for undergoing curative surgery with composite resection laparoscopically...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Noriko Wada, Yusuke Akamaru, Keisuke Otani, Masaya Higashiguchi, Takashi Nonoshita, Kentaro Nishida, Daisuke Takiuchi, Kazuya Sakata, Takashi Azama, Osakuni Morimoto, Hirofumi Ota, Masashi Kitada, Kunitaka Shibata
The recurrence ofgastric cancer has a poor prognosis in spite ofsystemic chemotherapy. We report three cases oflocal control ofdisease after the recurrence owing to intensity modulated radiation therapy(IMRT). The first case was a 66-yearsold man. He was received distal gastrectomy after neoadjuvant chemotherapy for advanced gastric cancer. Abdominal lymph node metastases appeared 1 year and 7 months after the surgery. IMRT was performed and he keeps CR for 1 year and 8 months. The second case was a 72-years-old man...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Sayaka Amano, Susumu Shibasaki, Shinpei Furuta, Shinichi Kadoya, Kenji Kikuchi, Yoshinori Ishida, Kazuki Inaba, Ichiro Uyama
A 76-year-old woman, complained of weight loss, was admitted in our hospital. After investigation, she was diagnosed with clinical Stage III B gastric cancer with invasion into the pancreas and transverse colon. After performing the staging laparoscopy and gastrojejunostomy for pyloric stenosis, she was treated with 2 courses of SOX therapy as neoadjuvant therapy, and subsequently underwent pancreaticoduodenectomy and right hemicolectomy combined with portal vein resection due to severe adhesion by the tumor...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tetsushi Kubota, Yasuhiro Choda, Toshiaki Morito, Soichiro Miyake, Michihiro Ishida, Daisuke Sato, Daisuke Sumitani, Kanyu Nakano, Masao Harano, Hiroyoshi Matsukawa, Yasutomo Ojima, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
A woman approximately 70-years-old with duodenal invasive advanced gastric cancer was referred to our hospital. Meta- stasis to lymph node(LN)No.13 was suspected based on FDG/PET-CT. For better curability, we selected neoadjuvant chemotherapy( NAC)with S-1 plus oxaliplatin(SOX therapy). After 3 courses of SOX, distal gastrectomy with D2(+No.13) lymphadenectomy was performed. Upon pathological evaluation, no viable cancer cells were found in the primary tumor, but viable cancer cells were identified in LN No...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kentaro Kawamitsu, Takashi Ooshiro, Daiki Nabekura, Kengo Kadoya, Ayami Sato, Tomoyuki Kitahara, Ryuichi Takagi, Ayako Hiranuma, Tasuku Urita, Yutaka Yoshida, Yu Sato, Hiroshi Tanaka, Makoto Nagashima, Shinichi Okazumi, Ryoji Kato
A 78-year-old man underwent an upper gastrointestinal endoscopy for evaluation of epigastralgia. Endoscopy revealed a bulky type 3 tumor in the lesser curvature of the upper body. A biopsy showed a poorly differentiated adenocarcinoma with signet ring cell carcinoma. Additionally, abdominal computed tomography(CT)showed bulky lymph node metastases leading to a diagnosis of cT3N2M0, Stage III A carcinoma. Following administration of 2 courses of neoadjuvant chemotherapy (NAC)using S-1/cisplatin(CDDP), CT revealed significant regression of the primary lesion and lymph nodes...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hideki Shimaoka, Ryosuke Shibata, Yasuhito Hosoda, Yosuke Hirano, Taro Munechika, Kimihiro Yonemitsu, Yasushi Ishii, Tatsuya Okamoto, Hiroshi Maeno, Tomoaki Noritomi, Takahisa Yoshida, Katsuo Sueishi
A 69-year-old man, who had undergone distal gastrectomy for duodenal ulcer, was diagnosed with remnant gastric cancer and jejunal mesenteric lymph node metastasis. To improve curability, we planned 2 courses of S-1 and cisplatin therapy. After chemotherapy, primary lesion and lymph node metastases reduced in size drastically. Completion gastrectomy and lymph node dissection were performed with curative intent. The tumor was found to have a pathological complete response(pCR) to chemotherapy on histological examination...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Zhi-Feng Miao, Xing-Yu Liu, Zhen-Ning Wang, Ting-Ting Zhao, Ying-Ying Xu, Yong-Xi Song, Jin-Yu Huang, Hao Xu, Hui-Mian Xu
BACKGROUND: Neoadjuvant chemotherapy (NAC) is extensively used in the treatment of patients with gastric cancer (GC), particularly in high risk, advanced gastric cancer. Previous trials testing the efficacy of NAC have reported inconsistent results. METHODS: This study compares the combined use of NAC and surgery with surgery alone for GC by using a meta-analytic approach. We performed an electronic search of PubMed, EmBase, and the Cochrane Library to identify randomized controlled trials (RCTs) on NAC published before Oct 2015...
January 31, 2018: BMC Cancer
Tomoaki Bekki, Nobuaki Fujikuni, Kazuaki Tanabe, Shuji Yonehara, Hironobu Amano, Toshio Noriyuki, Masahiro Nakahara
BACKGROUND: Gastric carcinosarcoma with severe venous invasion is extremely rare, and to the best of our knowledge, this is the first reported case. CASE PRESENTATION: A 79-year-old man visited the Onomichi General Hospital following abnormal upper gastrointestinal series findings. Laboratory data demonstrated no anemia, and the serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels were not elevated. Endoscopy identified a Borrmann type III lesion in the cardiac end of the stomach...
January 30, 2018: Surgical Case Reports
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