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Perioperative chemotherapy and gastric cancer

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https://www.readbyqxmd.com/read/28276825/perioperative-chemotherapy-for-resectable-gastric-cancer-what-is-the-evidence
#1
Erling A Bringeland, Hans H Wasmuth, Jon E Grønbech
The UK MAGIC trial published in 2006 was the first RCT to identify improved long-term survival rates using preoperative chemotherapy for resectable gastric or gastroesophageal cancer. Overnight, the treatment regimen impacted European guidelines. However, the majority of patients underwent limited lymph node dissection, and analyses of the rates of curative resection, downsizing and downstaging were not by intention to treat, rightfully raising concerns about their validity. For the subset of true gastric cancers, meta-analyses may even question the claims of improved long-term survival rates by present-day regimens...
February 28, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28275301/surgery-for-gastric-cancer-patients-of-age-85-and-older-multicenter-survey
#2
Hirotaka Konishi, Daisuke Ichikawa, Hiroshi Itoh, Kenichiro Fukuda, Naoki Kakihara, Manabu Takemura, Kaori Okugawa, Kiyoshi Uchiyama, Masashi Nakata, Hiroshi Nishi, Toshiyuki Kosuga, Shuhei Komatsu, Kazuma Okamoto, Eigo Otsuji
AIM: To investigate the surgical therapies for gastric cancer (GC) patients of age 85 or older in a multicenter survey. METHODS: Therapeutic opportunities for elderly GC patients have expanded in conjunction with extended life expectancy. However, the number of cases encountered in a single institution is usually very small and surgical therapies for elderly GC patients have not yet been standardized completely. In the present study, a total of 134 GC patients of age 85 or older who underwent surgery in 9 related facilities were retrospectively investigated...
February 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28251375/adjuvant-therapy-for-locally-advanced-gastric-cancer
#3
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/28243814/dna-diagnosis-of-peritoneal-fluid-cytology-test-by-cdo1-promoter-dna-hypermethylation-in-gastric-cancer
#4
Hideki Ushiku, Keishi Yamashita, Akira Ema, Naoko Minatani, Mariko Kikuchi, Ken Kojo, Keigo Yokoi, Toshimichi Tanaka, Nobuyuki Nishizawa, Satoru Ishii, Kei Hosoda, Hiromitsu Moriya, Hiroaki Mieno, Natsuya Katada, Shiro Kikuchi, Hiroshi Katoh, Masahiko Watanabe
BACKGROUND: Minimal residual disease of the peritoneum is challenging for early cancer detection in gastric cancer (GC). Utility of PCR amplification of cancer-derived DNA has been considered feasible due to its molecular stability, however such markers have never been available in GC clinics. We recently discovered cancer-specific methylation of CDO1 gene in GC, and investigated the clinical potential to detect the minimal residual disease. METHODS: One hundred and two GC patients were investigated for peritoneal fluid cytology test (CY), and detection level of the promoter DNA methylation of CDO1 gene was assessed by quantitative methylation specific PCR (Q-MSP) in the sediments (DNA CY)...
February 27, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28241187/mismatch-repair-deficiency-microsatellite-instability-and-survival-an-exploratory-analysis-of-the-medical-research-council-adjuvant-gastric-infusional-chemotherapy-magic-trial
#5
Elizabeth C Smyth, Andrew Wotherspoon, Clare Peckitt, David Gonzalez, Sanna Hulkki-Wilson, Zakaria Eltahir, Matteo Fassan, Massimo Rugge, Nicola Valeri, Alicia Okines, Madeleine Hewish, William Allum, Sally Stenning, Matthew Nankivell, Ruth Langley, David Cunningham
Importance: Mismatch repair (MMR) deficiency (MMRD) and microsatellite instability (MSI) are prognostic for survival in many cancers and for resistance to fluoropyrimidines in early colon cancer. However, the effect of MMRD and MSI in curatively resected gastric cancer treated with perioperative chemotherapy is unknown. Objective: To examine the association among MMRD, MSI, and survival in patients with resectable gastroesophageal cancer randomized to surgery alone or perioperative epirubicin, cisplatin, and fluorouracil chemotherapy in the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial...
February 23, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28118758/molecular-classification-of-gastric-cancer
#6
Christoph Röcken
Gastric cancer is among the most common cancers worldwide. Despite declining incidences, the prognosis remains dismal in Western countries and is better in Asian countries with national cancer screening programs. Complete endoscopic or surgical resection of the primary tumor with or without lymphadenectomy offers the only chance of cure in the early stage of the disease. Survival of more locally advanced gastric cancers was improved by the introduction of perioperative, adjuvant and palliative chemotherapy...
March 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28044374/histopathological-regression-of-gastric-adenocarcinoma-after-neoadjuvant-therapy-a-critical-review
#7
REVIEW
Eduardo Henrique Cunha Neves Filho, Rosane Oliveira de Sant'Ana, Luiz Vianney Saldanha Cidrão Nunes, Adriana Pinheiro Bezerra Pires, Maria do Perpétuo Socorro Saldanha da Cunha
As the perioperative chemotherapy has been widely implemented on the management of gastric cancer patients, heterogeneity of clinical outcomes has been evidenced in parallel to different histopathological regression pattern of gastric cancer cells. Tumor histological response to preoperative therapy has been graded by various systems in order to categorize the amount of regressive changes induced by chemotherapy in relation to residual tumor. In this context, tumor regression grading (TRG) systems might provide important prognostic information as the variety of tumor response may imply on different clinical outcomes with impact in survival rates...
February 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/27987041/prevalence-of-deep-venous-thrombosis-detected-by-ultrasonography-before-surgery-in-patients-with-gastric-cancer-a-retrospective-study-of-1140-consecutive-patients
#8
Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Tokunaga, Rie Makuuchi, Kei Iida, Kazuhide Nanri, Masashi Yoneyama, Masanori Terashima
BACKGROUND: The prevalence of deep venous thrombosis (DVT) in patients with gastric cancer before surgery is unknown. This study aimed to clarify the risk factors for DVT of the lower extremities in patients with gastric cancer before surgery and to evaluate the usefulness of ultrasonographic screening for prevention of postoperative pulmonary thromboembolism (PTE). METHODS: Patients who had undergone lower-extremity venous ultrasonography before surgery for gastric cancer were retrospectively analyzed...
December 16, 2016: Gastric Cancer
https://www.readbyqxmd.com/read/27776843/histopathological-regression-after-neoadjuvant-docetaxel-oxaliplatin-fluorouracil-and-leucovorin-versus-epirubicin-cisplatin-and-fluorouracil-or-capecitabine-in-patients-with-resectable-gastric-or-gastro-oesophageal-junction-adenocarcinoma-flot4-aio-results
#9
Salah-Eddin Al-Batran, Ralf D Hofheinz, Claudia Pauligk, Hans-Georg Kopp, Georg Martin Haag, Kim Barbara Luley, Johannes Meiler, Nils Homann, Sylvie Lorenzen, Harald Schmalenberg, Stephan Probst, Michael Koenigsmann, Matthias Egger, Nicole Prasnikar, Karel Caca, Jörg Trojan, Uwe M Martens, Andreas Block, Wolfgang Fischbach, Rolf Mahlberg, Michael Clemens, Gerald Illerhaus, Katja Zirlik, Dirk M Behringer, Wolff Schmiegel, Michael Pohl, Michael Heike, Ulrich Ronellenfitsch, Martin Schuler, Wolf O Bechstein, Alfred Königsrainer, Timo Gaiser, Peter Schirmacher, Wael Hozaeel, Alexander Reichart, Thorsten O Goetze, Mark Sievert, Elke Jäger, Stefan Mönig, Andrea Tannapfel
BACKGROUND: Docetaxel-based chemotherapy is effective in metastatic gastric and gastro-oesophageal junction adenocarcinoma, but has not yet been evaluated in the context of resectable patients. Here we report findings from the phase 2 part of the phase 2/3 FLOT4 trial, which compared histopathological regression in patients treated with a docetaxel-based triplet chemotherapy versus an anthracycline-based triplet chemotherapy before surgical resection. METHODS: In this randomised, open-label, phase 2/3 study, eligible participants were recruited from 28 German oncology centres...
December 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27697984/multimodality-therapy-of-localized-gastric-adenocarcinoma
#10
REVIEW
Brian Badgwell
Surgical resection is the primary method of obtaining a potential cure for patients with gastric adenocarcinoma. However, chemotherapy or chemoradiotherapy offer significant improvement in survival over surgery alone. Much of the difficulty in deciding the optimal treatment strategy is choosing between perioperative chemotherapy or adjuvant chemoradiotherapy. Adding to the complexity is the potential for incorporating treatment strategies based on clinical trials performed in Asia. There is likely a difference in tumor biology between Eastern and Western patients with gastric adenocarcinoma, in addition to the clear differences in screening, pathologic assessment, and surgical technique...
October 2016: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/27644906/gastric-cancer-adjuvant-therapy
#11
REVIEW
Florian Lordick, Masanori Terashima
From a global perspective, gastric cancer is one of the most common and lethal forms of cancer. The incidence of gastric cancer is very high in East Asia and varies considerably in countries of the Western hemisphere. Even after curative resection, the relapse rates are high in stages II and III. Therefore, adjuvant treatment with chemotherapy has been studied with positive results, especially in East Asian populations. In the Western World, where many locally advanced and borderline resectable gastric cancers are diagnosed, perioperative chemotherapy has become a standard of care...
August 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27574566/-magic-of-our-gastric-cancer-results-on-perioperative-chemotherapy
#12
Carlos León-Espinoza, Fernando López-Mozos, Roberto Marti-Obiol, Marina Garces-Albir, Joaquin Ortega-Serrano
AIM: To determine reproducibility of perioperative chemotherapy for gastric cancer (GC) on our settings by identifying patient's overall survival and comparing them to larger studies. METHODS: Retrospective analysis of our series, where we present our eleven-year's experience on GC managed according to perioperative approach of three preoperative chemotherapy cycles followed by surgery and finally three postoperative chemotherapy cycles. Chemotherapic scheme used was Xelox (Oxaliplatin and Capecitabine)...
August 15, 2016: World Journal of Gastrointestinal Pathophysiology
https://www.readbyqxmd.com/read/27553665/conversion-therapy-for-inoperable-advanced-gastric-cancer-patients-by-docetaxel-cisplatin-and-s-1-dcs-chemotherapy-a-multi-institutional-retrospective-study
#13
Yasushi Sato, Hiroyuki Ohnuma, Takayuki Nobuoka, Masahiro Hirakawa, Tamotsu Sagawa, Koshi Fujikawa, Yasuo Takahashi, Minami Shinya, Shinich Katsuki, Minoru Takahashi, Masahiro Maeda, Yutaka Okagawa, Uemura Naoki, Syouhei Kikuch, Koichi Okamoto, Hiroshi Miyamoto, Mitsuo Shimada, Takemasa Ichiro, Junji Kato, Tetsuji Takayama
BACKGROUND: Conversion therapy is an option for unresectable metastatic gastric cancer when distant metastases are controlled by chemotherapy; however, the feasibility and efficacy remain unclear. This study aimed to assess the feasibility and efficacy of conversion therapy in patients with initially unresectable gastric cancer treated with docetaxel, cisplatin, and S-1 (DCS) chemotherapy by evaluating clinical outcomes. METHODS: One hundred unresectable metastatic gastric cancer patients, enrolled in three DCS chemotherapy clinical trials, were retrospectively evaluated...
August 23, 2016: Gastric Cancer
https://www.readbyqxmd.com/read/27538392/original-article-role-of-adjuvant-chemotherapy-in-a-perioperative-chemotherapy-regimen-for-gastric-cancer
#14
Sven Lichthardt, Alexander Kerscher, Ulrich A Dietz, Christian Jurowich, Volker Kunzmann, Burkhard H A von Rahden, Christoph-Thomas Germer, Armin Wiegering
BACKGROUND: Multimodal treatment strategies - perioperative chemotherapy (CTx) and radical surgery - are currently accepted as treatment standard for locally advanced gastric cancer. However, the role of adjuvant postoperative CTx (postCTx) in addition to neoadjuvant preoperative CTx (preCTx) in this setting remains controversial. METHODS: Between 4/2006 and 12/2013, 116 patients with locally advanced gastric cancer were treated with preCTx. 72 patients (62 %), in whom complete tumor resection (R0, subtotal/total gastrectomy with D2-lymphadenectomy) was achieved, were divided into two groups, one of which receiving adjuvant therapy (n = 52) and one without (n = 20)...
2016: BMC Cancer
https://www.readbyqxmd.com/read/27523409/-radiotherapy-in-cancers-of-the-oesophagus-the-gastric-cardia-and-the-stomach
#15
G Créhange, F Huguet, L Quero, T V N'Guyen, X Mirabel, T Lacornerie
Localized oesophageal and gastric cancers have a poor prognosis. In oesophageal cancer, external radiotherapy combined with concomitant chemotherapy is accepted as part of the therapeutic armamentarium in a curative intent in the preoperative setting for resectable tumours; or without surgery in inoperable patients or non-resectable tumours due to wide local and/or regional extension. Data from the literature show conflicting results with no clinical evidence in favour of either a unique dose protocol or consensual target volume definition in the setting of exclusive chemoradiation...
September 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/27519527/which-is-better-for-gastric-cancer-patients-perioperative-or-adjuvant-chemotherapy-a-meta-analysis
#16
Jun-Hua Zhao, Peng Gao, Yong-Xi Song, Jing-Xu Sun, Xiao-Wan Chen, Bin Ma, Yu-Chong Yang, Zhen-Ning Wang
BACKGROUND: The preferred chemotherapy method for gastric cancer continues to be matter of debate. We performed a meta-analysis to comparing prognosis and safety between perioperative chemotherapy and adjuvant chemotherapy to identify the better chemotherapy option for gastric cancer. METHODS: We searched the PubMed, EMBASE, Cochrane Library, and Ovid databases for eligible studies until February 2016. The main endpoints were prognostic value (hazard ratio [HR] for overall survival [OS] and 1-, 2-, 3-, and 5-year survival rate), response rate of chemotherapy, radical resection rate, post-operative complication rate, and adverse effects of chemotherapy...
2016: BMC Cancer
https://www.readbyqxmd.com/read/27442682/perioperative-transfusion-of-leukocyte-depleted-blood-products-in-gastric-cancer-patients-negatively-influences-oncologic-outcome-a-retrospective-propensity-score-weighted-analysis-on-610-curatively-resected-gastric-cancer-patients
#17
Daniel Reim, Andreas N Strobl, Christian Buchner, Rebekka Schirren, Werner Mueller, Peter Luppa, Donna Pauler Ankerst, Helmut Friess, Alexander Novotny
The influence of perioperative transfusion (PT) on outcome following surgery for gastric cancer (GC) remains controversial, with randomized trials lacking and observational series confounded by patient risk factors. This analysis determines the association between reception of leukocyte-depleted blood products and post-operative survival for GC.Data from 610 patients who underwent curative surgery for GC in a German tertiary care clinic from 2001 to 2013 were included. Kaplan-Meier survival curves and Cox proportional hazards regression were applied to determine the association of PT and clinical and patient risk factors for overall and relapse-free survival...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27422110/improving-outcomes-in-resectable-gastric-cancer-a-review-of-current-and-future-strategies
#18
REVIEW
Bryan A Chan, Raymond W Jang, Rebecca K S Wong, Carol J Swallow, Gail E Darling, Elena Elimova
Gastric cancer is a highly fatal malignancy, and surgery alone often does not provide a cure, even for relatively early stages of disease. Various approaches have been adopted around the world to improve surgical outcomes; however, there currently is no global consensus with regard to the extent of surgery or the timing and choice of chemotherapy and radiation. Here we review the evidence supporting current approaches to resectable gastric cancer, including discussion of the optimal extent of surgery and lymphadenectomy, adjuvant chemotherapy, postoperative chemotherapy with chemoradiation, and perioperative chemotherapy...
July 2016: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/27406251/-new-s3-guideline-for-esophageal-cancer-important-surgical-aspects
#19
A H Hölscher, M Stahl, H Messmann, M Stuschke, H J Meyer, R Porschen
The current German S3 guideline represents the recommendations for the diagnosis and therapy of squamous cell carcinomas and adenocarcinomas of the esophagus based on evidence from the literature and interdisciplinary expert consensus. Esophagogastroscopy with biopsy, endosonography, and spiral CT scan of the neck, thorax, and abdomen are decisive in staging and the choice of therapy. For a curative approach, surgery, especially transthoracic esophagectomy and gastric pull-up, is the most important therapeutic option, except in the case of mucosal carcinomas or cervical squamous cell carcinomas...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27330364/treatment-of-peritoneal-surface-malignancies-with-hyperthermic-intraperitoneal-chemotherapy-current-perspectives
#20
REVIEW
J Spiliotis, E Halkia, E de Bree
Peritoneal carcinomatosis (ptc) represents advanced malignant disease and has generally been associated with a grim prognosis. Peritoneal surface malignancy is often the major source of morbidity and mortality; it is of major concern in cancer management. Although ptc is categorized as metastatic disease, it represents a special disease pattern considered to be a locoregional disease limited to the abdominal cavity. The combination of cytoreductive surgery (crs) and intraoperative hyperthermic intraperitoneal chemotherapy (hipec) has successfully been used as locoregional treatment for selected patients with ptc from gastric, colorectal, and ovarian cancer; with mesothelioma; and with pseudomyxoma peritonei...
June 2016: Current Oncology
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