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novel D2 adjuvant therapy

Tomoyuki Irino, Hiroya Takeuchi, Masanori Terashima, Toshifumi Wakai, Yuko Kitagawa
Gastric cancer (GC) poses a burden to patients across the globe as the third leading cause of cancer deaths worldwide. Incidence of GC is particularly high in Asian countries, which is attributed to the prevalence of Helicobacter pylori (H. pylori) infection and has prompted the establishment of unique treatment strategies. D2 gastrectomy, which was established in the 1950s in Japan, has served as a gold standard for locally advanced GC for over half a century. Since the beginning of the 21st century, endoscopic resection (ER) techniques and minimally invasive laparoscopic surgery have greatly changed the treatment of patients with early GC...
2017: American Society of Clinical Oncology Educational Book
L Chen, L G Ma, H Q Xi
The unresectable gastric cancer refers to be unable to accept radical gastrectomy because of advanced stage, which is mainly treated with adjuvant chemotherapy, and obtains only poor prognosis in the past. In recent years, however, some scholars found that the unresectable gastric cancer cases which were treated with systematic chemotherapy, radiochemotherapy, interventional therapy, hyperthermic intraperitoneal peroperative chemotherapy and so on, could be converted into resectable (radical D2 gastrectomy) cases successfully, and their survival time and quality of life are promoted significantly...
March 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Na Liu, Xin Wang
Recently the standard treatment for advanced gastric cancer is the multimodal therapies associated with complete surgical resection of cancer (D2 dissection) and now more and more clinical attentions have been paid to chemotherapy. It has been confirmed by several randomized phase III( clinical trials that adjuvant chemotherapy after D2 dissection can significantly improve patients' survival. But it is still in debate that perioperative chemotherapy(adjuvant and neoadjuvant) and postoperative radiotherapy can really bring survival benefits for gastric cancer patients who received curative D2 dissections...
October 2015: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Ulrich Hacker, Florian Lordick
Endoscopic resection is established in the treatment of early gastric cancer. More advanced gastric cancer requires gastrectomy and D2 lymphadenectomy. Perioperative chemotherapy improves overall survival in locally advanced gastric cancer representing a standard of care. Locally advanced adenocarcinomas of the esophago-gastric junction can alternatively be treated with concurrent radiochemotherapy. In metastatic disease, systemic chemotherapy improves survival, quality of life and symptom control. Trastuzumab plus chemotherapy should be used together with first-line chemotherapy in HER2 positive gastric cancer patients...
August 2015: Deutsche Medizinische Wochenschrift
M Fan, W Hu, Z Zhang
The INT0116 trial established the role of adjuvant chemoradiation (CRT) in the multidisciplinary approach to the management of locally advanced gastric cancer. However, whether adjuvant CRT is indispensable for patients undergoing D2 dissection remains undefined. The adjuvant chemoradiation therapy in stomach cancer (ARTIST) trial, which was designed to compare adjuvant chemotherapy to CRT, failed to demonstrate differences in disease-free and overall survival in the whole study group; however, subgroup analysis indicated that patients with lymph node metastasis may benefit from additional radiation...
July 2015: British Journal of Radiology
Elena Elimova, Hironori Shiozaki, Roopma Wadhwa, Kazuki Sudo, Qiongrong Chen, Jeannelyn S Estrella, Mariela A Blum, Brian Badgwell, Prajnan Das, Shumei Song, Jaffer A Ajani
Gastric cancer represents a serious health problem on a global scale. It is the second leading cause of cancer-related death worldwide. Novel therapeutic targets are desperately needed because the meager improvement in the cure rate of about 10% realized by adjunctive treatments to surgery is unacceptable as > 50% patients with localized gastric cancer succumb to their disease. Either postoperative chemoradiotherapy (United States), pre-and post-operative chemotherapy (Europe), and adjuvant chemotherapy after a D2 resection (Asia) can all be regarded as standards of care in the localized gastric cancer management...
October 14, 2014: World Journal of Gastroenterology: WJG
Neil D Merrett
After much controversy, multimodality therapy is now accepted worldwide as the gold standard for treatment of resectable bulky localized gastric cancer. There is significant regional variation in the style of multimodality treatment with adjuvant chemoradiation the North American standard, neoadjuvant chemotherapy preferred in Europe and Australasia, whilst adjuvant chemotherapy is preferred in Asia. With further standardization of surgery and D1+/D2 resections increasingly accepted world wide, and in particular in the West, as the surgical standard of care for potentially curable disease, it is timely to reassess the multimodality regimes being used...
September 28, 2014: World Journal of Gastroenterology: WJG
Toshifusa Nakajima, Masashi Fujii
After a long history of Dark Age of adjuvant chemotherapy for gastric cancer, definite evidences of survival benefit from adjuvant treatment have been reported since 2000s. These survival benefits are likely attributed to something new approach different from pervious studies. In 2001, South West Oncology Group INT0116 trial yielded survival benefit in curatively resected gastric cancer patients with postoperative chemoradiotherapy [5-fluorouracil (5-FU) + Leucovorin + radiotherapy], followed by positive result by MAGIC Trial, employing peri-operative(pre- and postoperative chemotherapy with Epirubicin, cisplatin (CDDP), 5-fluorouracil (ECF) regimen in patients with curative resection...
September 7, 2014: World Journal of Gastroenterology: WJG
C Röcken
Gastric cancer is the fourth most common tumor and the second most common cause of cancer-related deaths in the world. Approximately 70 % of the patients already have lymph node metastases at the time of the diagnosis leading to a median overall survival time of 16.7 months. Complete resection of the primary tumor with D2 lymphadenectomy offers the only chance of cure in the early stages of the disease. Survival of more locally advanced gastric cancer was improved by the introduction of perioperative, adjuvant and palliative chemotherapy of gastric cancer; however, the identification of novel predictive and diagnostic targets is urgently needed...
September 2013: Der Pathologe
Mariela A Blum, Taketa Takashi, Akihiro Suzuki, Jaffer A Ajani
Gastric cancer continues to be a fatal disease with majority of cases presenting in late stages. For patients with advanced disease, we can only recommend palliative therapy. For localized gastric cancer, the approaches vary in various regions of the world. In western countries, preoperative chemotherapy or adjuvant chemo-radiation is preferred; however in Asia, surgery followed by adjuvant chemotherapy is favored. The extent of the lymph node dissection also varies by region. D2 gastrectomy is difficult to implement in most western countries while it is standardized and is a routine in Asia...
March 2013: Journal of Surgical Oncology
Zhen Zhang
UNLABELLED: Radiotherapy has been an important component in the multidisciplinary treatment strategy of gastric cancer. INT0116 has showed the improvement of survival with adjuvant chemoradiation in resected gastric cancer. The benefit of adjuvant chemoradiation has been confirmed further in gastric cancer population. Recent reported ARTIST trial which all patients got D2 dissection has showed the benefit of adjuvant chemoradiation only seen in patients with lymph node positive. As the same observed in other two trail, ACT-GC and CLASSIC, extremely low local recurrence were reported in these trial...
June 2012: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Dalit Barkan, Jeffrey E Green
Recurrence of breast cancer often follows a long latent period in which there are no signs of cancer, and metastases may not become clinically apparent until many years after removal of the primary tumor and adjuvant therapy. A likely explanation of this phenomenon is that tumor cells have seeded metastatic sites, are resistant to conventional therapies, and remain dormant for long periods of time. The existence of dormant cancer cells at secondary sites has been described previously as quiescent solitary cells that neither proliferate nor undergo apoptosis...
2011: Journal of Visualized Experiments: JoVE
Mohammad Saleem, Nityanand Maddodi, Mohammad Abu Zaid, Naghma Khan, Bilal bin Hafeez, Mohammad Asim, Yewseok Suh, Jung-Mi Yun, Vijayasaradhi Setaluri, Hasan Mukhtar
PURPOSE: Poor prognosis of metastatic melanoma mandates the development of novel strategies for its treatment and prevention. In this study, the effect of lupeol, a diet-based triterpene, was determined on the growth and tumorigenicity of human melanoma cells in vitro and in vivo. EXPERIMENTAL DESIGN: Normal human melanocytes, and human metastatic (451Lu) and nonmetastatic (WM35) cells were treated with lupeol; its effect on growth, proliferation, and apoptosis were evaluated...
April 1, 2008: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Andreas Grimm, Arno Dimmler, Sebastian Stange, Apostolos Labanaris, Rolf Sauer, Gerhard Grabenbauer, Raymund E Horch
BACKGROUND AND PURPOSE: Despite the enormous therapeutic potential of modern radiotherapy, common side effects such as radiation-induced wound healing disorders remain a well-known clinical phenomenon. Topical negative pressure therapy (TNP) is a novel tool to alleviate intraoperative, percutaneous irradiation or brachytherapy. Since TNP has been shown to positively influence the perfusion of chronic, poorly vascularized wounds, the authors applied this therapeutic method to irradiated wounds and investigated the effect on tissue oxygenation in irradiated tissue in five patients...
March 2007: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Shusuke Mori, Hirofumi Kishimoto, Katsunori Tauchi, Kayoko Higuchi
Single-agent or combined chemotherapy with the novel oral fluoropyrimidine anticancer drug, S-1 (TS-1), has been reported to be useful for the treatment of advanced gastric cancer. Here, we report a patient with advanced gastric cancer achieving a complete response (CR) after 2 weeks of administration of S-1 as neoadjuvant chemotherapy. A 78-year-old woman with epigastric pain was diagnosed as having advanced gastric cancer. S-1 was administered orally, at a dose of 50 mg twice a day every day for 2 weeks, followed by a 2-week drug-free period...
2006: Gastric Cancer
Kun-Huei Yeh, Ann-Lii Cheng
Gastric cancer is the fourth leading cause of death from cancer in Taiwan. Complete surgical resection is the only potentially curative treatment for gastric cancer. Randomized trials have failed to show the superiority of D2 over D1 dissection, and comparisons showing higher survival rates following more extensive surgery in Japan may have been influenced at least in part by the fact that D1 dissection underestimates disease stage in Western populations. No studies have shown convincing evidence of a survival benefit from adjuvant chemotherapy...
March 2004: Journal of the Formosan Medical Association, Taiwan Yi Zhi
John S Macdonald
Many issues remain unclear in the management of gastric cancer. Randomized trials have failed to show the superiority of D2 over D1 dissection, and comparisons between countries showing higher survival rates following more extensive surgery may be influenced at least in part by the fact that D1 dissection underestimates disease stage in many patients. No studies have yet shown a benefit from adjuvant chemotherapy. However, the Southwest Oncology Group (SWOG) 9008 trial provides convincing evidence that a regimen of postoperative 5-fluorouracil (5-FU)-based chemoradiotherapy improves disease-free and overall survival when compared with observation alone...
2002: Gastric Cancer
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