Processes of Care in the Multidisciplinary Treatment of Gastric Cancer

Brar, Savtaj; Mahar, Alyson; Helyer, Lucy; Swallow, Carol J.; Law, Calvin; Paszat, Lawrence; Seevaratnam, Rajini; Cardoso, Roberta; McLeod, Robin S.; Dixon, Matthew; Yohanathan, Lavanya; Lourenço, Laércio Gomes; Bocicariu, Alina; Bekaii‐Saab, Tanios; Chau, Ian; Church, Neal; Coit, Daniel G.; Crane, Christopher H.; Earle, Craig C.; Mansfield, Paul F.; Marcon, Norman E.; Miner, Thomas J.; Noh, Sung Hoon; Porter, Geoff; Posner, Mitchell C.; Prachand, Vivek N.; Sano, Takeshi; Velde, Cornelis van de; Wong, Sandra L.; Coburn, Natalie

doi:10.1001/jamasurg.2013.3959

Cited by 37 publications

(34 citation statements)

References 33 publications

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“…The scale indicates complete cytoreduction (CC-0/1) and incomplete cytoreduction (CC -2/3), depending on the size of the peritoneal tumour that remained after cytoreduction. Thus, CC-0 indicates lack of residual disease; CC-1: the persisting nodules are smaller than 2.5mm; CC-2: such nodules are between 2.5mm and 2.5cm, and CC-3: the nodules are greater than 2,5cm [22]. Of note, complete cytoreduction (CC-1) is an equivalent to macroscopically non-radical resection (R2a).…”

Section: Results Of Cytoreductive Surgery and Hipecmentioning

confidence: 99%

“…Despite the evidence from the afore-mentioned metaanalysis, an international expert working group reached a consensus on intraperitoneal chemotherapy [22]. It was recognised as inapplicable in GC patients with Peritoneal Carcinomatosis Index (PCI) greater than 20, in patients with peritoneal and synchronous metastases to both ovaries or other distant organs, as well as in patients who underwent multivisceral resection for T4 tumour without the presence of peritoneal dissemination [22].…”

Section: Results Of Cytoreductive Surgery and Hipecmentioning

confidence: 99%

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Treatment of peritoneal metastases from gastric carcinoma

Polkowski

Rawicz‐Pruszyński

Mielko

et al. 2017

Current Issues in Pharmacy and Medical Sciences

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Patients with advanced gastric cancer and positive peritoneal cytology and/or peritoneal dissemination are deemed to be incurable and to hold dismal prognosis. So far, the only treatment option for these patients has been palliative systemic (chemo)therapy. However, for the last three decades, great progress has been made in attempts to treat (potential) peritoneal dissemination by means of complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) after preoperative systemic therapy. This review is focused on the recent achievements of this multimodal strategy. Additionally, the review stands as background for the 4th International Conference “Advances in Surgical Oncology” that was held at the Medical University of Lublin (Poland) in November 2017, and dedicated to cytoreductive surgery and HIPEC for advanced gastric cancer.

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Section: Results Of Cytoreductive Surgery and Hipecmentioning

confidence: 99%

Section: Results Of Cytoreductive Surgery and Hipecmentioning

confidence: 99%

Treatment of peritoneal metastases from gastric carcinoma

Polkowski

Rawicz‐Pruszyński

Mielko

et al. 2017

Current Issues in Pharmacy and Medical Sciences

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“…Evidence for this was provided by prospective studies of Gouzi, Bozzetti and Davies [11][12][13][14]. Most researchers consider that 4-5 cm is a safe enough margin for intestinal tumours, but 6-8 cm for diffuse tumours; according to Lauren [11,[14][15][16]. A retrospective study by Harrison et al evaluated 98 patients with cancer in the proximal part of the stomach, (65 after SG and 33 after TG), and found no differences in survival or recurrence rates, however the QoL had not been measured.…”

Section: The Extent Of Resectionmentioning

confidence: 99%

“…The area of lymphadenectomy can be limited to D1 (lymph nodes around the stomach) for T1N0 advancement. The area of D2 lymphadenectomy includes the lymph nodes of the celiac artery, the left gastric artery, common hepatic artery and the surroundings of the splenic artery along with the hilus lienis (splenic cacity) which in isolated cases may require selective removal of [16]. Despite attempts for globally harmonising standards, there are important differences in how the extents of radical resection are approached between Asia with the US and Europe.…”

Section: The Extent Of Resectionmentioning

confidence: 99%

Surgical treatment of gastric cancer: then and now

Olesiński

2017

Nowotwory. Journal of Oncology

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Gastric cancer is one of the most commonly diagnosed cancers found in the world (980,000 new cases in 2008), but its treatment outcomes are poor, particularly in the European Union (EU); only a 25% survival after 5 years. Despite advances made in combination therapy, the only effective treatment that remains is surgery. The extent of gastric resection and lymphadenectomy, along with reconstruction methods, have systematically evolved over the last 100 years. This paper discusses both present day recommendations and the pathways that were taken enabling modern gastric surgery to develop. NOWOTWORY J Oncol 2016; 66, 5: 408-414

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“…Little is known about the actual burden of IFCC positivity and its accuracy for predicting an outcome. Moreover, a lack of consensus exists in its routine practice, methods of detection 6, and association with clinical pathological variables.…”

Section: Introductionmentioning

confidence: 99%

Detection value of free cancer cells in peritoneal washing in gastric cancer: a systematic review and meta-analysis

Tustumi¹,

Bernardo²,

Dias³

et al. 2016

Clinics

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Intraperitoneal free cancer cells in gastric adenocarcinoma are associated with a poor outcome. However, the true prognostic value of intraperitoneal free cancer cells is still unclear, leading to a lack of consensus in the management of gastric cancer. The aim of the present study is to perform a systematic review and meta-analysis to analyze intraperitoneal free cancer cells-positive patients with regard to tumor oncologic stage, recurrence, grade of cellular differentiation, and survival rates and to analyze the clinical significance of intraperitoneal free cancer cells with regard to prognosis. Databases were searched up to January 2016 for prognostic factors associated with intraperitoneal free cancer cells, including oncologic stage, depth of neoplasm invasion, lymph nodal spread, differentiation grade of the tumor, and recurrence and survival rates. A total of 100 studies were identified. Meta-analysis revealed a clear association between intraperitoneal free cancer cells and a poor prognosis. intraperitoneal free cancer cells -positive patients had higher rates of nodal spread (risk difference: 0.29; p<0.01), serosal invasion (risk difference: 0.43; p<0.01), recurrence (after 60 months of follow-up, risk difference: 0.44; p<0.01), and mortality (after 60 months of follow-up, risk difference: 0.34; p<0.01). Intraperitoneal free cancer cells are associated with a poor outcome in gastric cancer. This surrogate biomarker should be used to guide therapy both prior to and after surgery.

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Processes of Care in the Multidisciplinary Treatment of Gastric Cancer

Abstract: Patients with GC being treated with curative intent should be considered for multimodal treatment. For patients with incurable disease, surgical interventions should be considered only for the management of major bleeding or obstruction.

Cited by 37 publications

References 33 publications

Treatment of peritoneal metastases from gastric carcinoma

Treatment of peritoneal metastases from gastric carcinoma

Surgical treatment of gastric cancer: then and now

Detection value of free cancer cells in peritoneal washing in gastric cancer: a systematic review and meta-analysis

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