Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Neoadjuvant Treatment for Gastric Cancer

  • Schuhmacher, Christoph (Department of Surgery, Klinikum rechts der Isar der Technischen Universitaet Muenchen) ;
  • Reim, Daniel (Department of Surgery, Klinikum rechts der Isar der Technischen Universitaet Muenchen) ;
  • Novotny, Alexander (Department of Surgery, Klinikum rechts der Isar der Technischen Universitaet Muenchen)
  • Received : 2013.04.08
  • Accepted : 2013.04.18
  • Published : 2013.06.30
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Abstract

Surgery is still considered to be the mainstay for the treatment of localized gastric cancer with negative margins (R0-resection) and an adequate lymph-node-dissection (D2-lymphadenectomy). Unfortunately, most cases of gastric cancer are only diagnosed at an advanced stage due to frequent recurrences after primary resection in curative intent. In order to improve prognosis after curative resection, in the recent past, patients with locally advanced tumors were subjected to a pre-, peri-, or postoperative treatment. Interestingly, postoperative chemotherapy has significantly improved survival after gastric resection in Asia, adjuvant radiochemotherapy is favored in North America and perioperative chemotherapy is considered as a treatment of choice in Europe indicating region specific approach towards the treatment. Recently there has also been growing evidence of positive outcomes of neoadjuvant radiochemotherapy on patient survival. In the present article, we discuss the concepts of neoadjuvant treatment approach and provide recommendations to surgeons based on current evidence.

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References

  1. Meyer HJ, Hölscher AH, Lordick F, Messmann H, Mönig S, Schumacher C, et al. Current S3 guidelines on surgical treatment of gastric carcinoma. Chirurg 2012;83:31-37. https://doi.org/10.1007/s00104-011-2149-x
  2. Agboola O. Adjuvant treatment in gastric cancer. Cancer Treat Rev 1994;20:217-240. https://doi.org/10.1016/0305-7372(94)90001-9
  3. Middleton G, Cunningham D. Current options in the management of gastrointestinal cancer. Ann Oncol 1995;6 Suppl 1:17-25.
  4. Wilke H, Preusser P, Fink U, Gunzer U, Meyer HJ, Meyer J, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. J Clin Oncol 1989;7:1318-1326.
  5. D'Ugo D, Rausei S, Biondi A, Persiani R. Preoperative treatment and surgery in gastric cancer: friends or foes? Lancet Oncol 2009;10:191-195. https://doi.org/10.1016/S1470-2045(09)70021-X
  6. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11-20. https://doi.org/10.1056/NEJMoa055531
  7. Ychou M, Boige V, Pignon JP, Conroy T, Bouché O, Lebreton G, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 2011;29:1715-1721. https://doi.org/10.1200/JCO.2010.33.0597
  8. Schuhmacher C, Gretschel S, Lordick F, Reichardt P, Hohenberger W, Eisenberger CF, et al. Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer randomized trial 40954. J Clin Oncol 2010;28:5210-5218. https://doi.org/10.1200/JCO.2009.26.6114
  9. Stahl M, Walz MK, Stuschke M, Lehmann N, Meyer HJ, Riera- Knorrenschild J, et al. Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol 2009;27:851-856. https://doi.org/10.1200/JCO.2008.17.0506
  10. van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, et al; CROSS Group. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 2012;366:2074-2084. https://doi.org/10.1056/NEJMoa1112088
  11. Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A; ACTS-GC Group. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 2007;357:1810-1820. https://doi.org/10.1056/NEJMoa072252
  12. Sasako M, Kinoshita T, Furukawa H, Yamaguchi T, Nashimoto A, Fujii M, et al. Five-year results of the randomized phase III trial comparing S-1 monotherapy versus surgery alone for stage II/III gastric cancer patients after curative D2 gastrectomy (ACTS-GC study). Ann Oncol 2010;21:viii225-249.
  13. Ott K, Lordick F, Blank S, Büchler M. Gastric cancer: surgery in 2011. Langenbecks Arch Surg 2011;396:743-758. https://doi.org/10.1007/s00423-010-0738-7
  14. Feussner H, Omote K, Fink U, Walker SJ, Siewert JR. Pretherapeutic laparoscopic staging in advanced gastric carcinoma. Endoscopy 1999;31:342-347. https://doi.org/10.1055/s-1999-28
  15. Li H, Zhu F, Cao Y, Zhai L, Lin T. Meta-analyses of randomized trials assessing the effect of neoadjuvant chemotherapy in locally advanced gastric cancer. J Clin Oncol (Meeting Abstracts) 2010;28:4042.
  16. Ronellenfitsch U, Schwarzbach M, Hofheinz R, Kienle P, Hohenberger P, Jensen K, et al; GE Adenocarcinoma Meta-analysis Group. Meta-analysis of preoperative chemotherapy (CTX) versus primary surgery for locoregionally advanced adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus (GE adenocarcinoma). J Clin Oncol 2010;28:15s.
  17. Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al; Upper Gastrointestinal Clinical Studies Group of the National Cancer Research Institute of the United Kingdom. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 2008;358:36-46. https://doi.org/10.1056/NEJMoa073149
  18. Fiorica F, Cartei F, Enea M, Licata A, Cabibbo G, Carau B, et al. The impact of radiotherapy on survival in resectable gastric carcinoma: a meta-analysis of literature data. Cancer Treat Rev 2007;33:729-740. https://doi.org/10.1016/j.ctrv.2007.08.005
  19. Gebski V, Burmeister B, Smithers BM, Foo K, Zalcberg J, Simes J; Australasian Gastro-Intestinal Trials Group. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol 2007;8:226-234. https://doi.org/10.1016/S1470-2045(07)70039-6
  20. Urschel JD, Vasan H. A meta-analysis of randomized controlled trials that compared neoadjuvant chemoradiation and surgery to surgery alone for resectable esophageal cancer. Am J Surg 2003;185:538-543. https://doi.org/10.1016/S0002-9610(03)00066-7
  21. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-730. https://doi.org/10.1056/NEJMoa010187
  22. Botterweck AA, Schouten LJ, Volovics A, Dorant E, van Den Brandt PA. Trends in incidence of adenocarcinoma of the oesophagus and gastric cardia in ten European countries. Int J Epidemiol 2000;29:645-654. https://doi.org/10.1093/ije/29.4.645
  23. Powell J, McConkey CC. The rising trend in oesophageal adenocarcinoma and gastric cardia. Eur J Cancer Prev 1992;1:265-269. https://doi.org/10.1097/00008469-199204000-00008
  24. Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 1991;265:1287-1289. https://doi.org/10.1001/jama.1991.03460100089030
  25. Okabayashi T, Gotoda T, Kondo H, Inui T, Ono H, Saito D, et al. Early carcinoma of the gastric cardia in Japan: is it different from that in the West? Cancer 2000;89:2555-2559. https://doi.org/10.1002/1097-0142(20001215)89:12<2555::AID-CNCR6>3.0.CO;2-R
  26. Chung JW, Lee GH, Choi KS, Kim DH, Jung KW, Song HJ, et al. Unchanging trend of esophagogastric junction adenocarcinoma in Korea: experience at a single institution based on Siewert's classification. Dis Esophagus 2009;22:676-681. https://doi.org/10.1111/j.1442-2050.2009.00946.x
  27. Reim D, Gertler R, Novotny A, Becker K, zum Büschenfelde CM, Ebert M, et al. Adenocarcinomas of the esophagogastric junction are more likely to respond to preoperative chemotherapy than distal gastric cancer. Ann Surg Oncol 2012;19:2108- 2118. https://doi.org/10.1245/s10434-011-2147-8
  28. Ajani JA, Faust J, Ikeda K, Yao JC, Anbe H, Carr KL, et al. Phase I pharmacokinetic study of S-1 plus cisplatin in patients with advanced gastric carcinoma. J Clin Oncol 2005;23:6957- 6965. https://doi.org/10.1200/JCO.2005.01.917
  29. Messager M, Lefevre JH, Pichot-Delahaye V, Souadka A, Piessen G, Mariette C; FREGAT working group - FRENCH. The impact of perioperative chemotherapy on survival in patients with gastric signet ring cell adenocarcinoma: a multicenter comparative study. Ann Surg 2011;254:684-693. https://doi.org/10.1097/SLA.0b013e3182352647

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