The Prognostic Significance of an R1 Resection in Gastric Cancer Patients Treated with Adjuvant Chemoradiotherapy

Stiekema, J.; Trip, Anouk Kirsten; Jansen, Edwin P.M.; Boot, H.; Cats, Annemieke; Balagué, Olga; Verheij, Marcel; Sandick, Johanna W. van

doi:10.1245/s10434-013-3397-4

Cited by 42 publications

(26 citation statements)

References 29 publications

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“…However, other randomised and non-randomised data suggest potential benefits from postoperative CRT even after optimal D2 dissection [I, B] [42][43][44][45], and this is the subject of ongoing randomised trials. Regarding patients who have had a microscopically incomplete resection, a retrospective comparison of the Dutch D1D2 trial has suggested significant improvements in OS and local recurrence rates with use of CRT after an R1 resection, a finding that has been confirmed by other retrospective series [IV, B] [41,46].…”

Section: Perioperative Chemotherapymentioning

confidence: 81%

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

et al. 2016

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Section: Perioperative Chemotherapymentioning

confidence: 81%

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

et al. 2016

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“…, was ebenfalls die genaue Indikationsstellung zur Nachresektion untermauert. Eine Reihe von retrospektiven Fallsammlungen weist unabhängig voneinander darauf hin, dass für Patienten mit R1-Situation eine postoperative Radiochemotherapie nicht nur die lokale Rückfallrate senkt, sondern auch das Überleben verbessert[509,510,515,516]. Patienten mit Adenokarzinom des Magens und des ösophagogastralen Übergangs mit primär nich resezierbaren Tumoren, lokalen Rückfällen oder makroskopischen Resttumoren nach inkompletter Resektion[517].…”

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S3-Leitlinie Magenkarzinom – Diagnostik und Therapie der Adenokarzinome des Magens und des ösophagogastralen Übergangs – Langversion 2.0 – August 2019. AWMF-Registernummer: 032/009OL

Moehler¹,

Al-Batran²,

Andus³

et al. 2019

Z Gastroenterol

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“…This can be explained that patients undergoing total gastrectomy probably reflects larger tumors and unfavorable proximal lesions that prompt such a procedure. A positive resection margin was shown to be an independent adverse factor for survival in several surgical series before the advent of adjuvant CRT regarding patients who have had a microscopically incomplete resection, a retrospective comparison of the Dutch D1D2 trial has suggested significant improvements in OS and local recurrence rates with use of CRT after an R1 resection [29,30]. In our study, the surgical margin alter significantly outcome (Figure 4).…”

Section: Discussionmentioning

confidence: 48%

Adjuvant Chemoradiation for Localized Gastric Adenocarcinoma: An Institutional Experience

Touil¹,

Loughlimi²,

Abbassi³

et al. 2017

J Cancer Sci Ther

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BackgroundGastric cancer is the second leading cause of cancer related death among men and the fourth among women, and thus represents a significant global health concern [1]. The disease is commonly diagnosed at a locally advanced stage, and surgery remains the main treatment; The overall survival rate of patients who underwent surgery alone is about 45% at 5 years, that has undergone few changes over the last decades [2,3].The curative treatment of gastric cancer requires surgical resection in less than 40% of cases [2,3]. Independent risk factors in the literature are tumor size (>4 cm), age (>70 years), proximal location, diffuse type of Lauren classification, tumor residue, Deep invasion (T3-T4), and the ratio of involved lymph nodes/total number (>20%) [4,5]. Locoregional recurrences on the tumor bed, on the anastomosis or in lymph nodes occur in 40% to 65% of the patients after resection with curative intent [6,7]. The frequency of this relapse makes regional radiotherapy an attractive possibility for adjuvant therapy [8].Various chemotherapy regimens used to prevent relapse and improve the poor survival rates provide small but statistically significant clinical benefit [9,10]. Finally, the intergroup of gastrointestinal cancers was the first to demonstrate in a phase III trial that concomitant radio-chemotherapy after complete gastric resection improves median relapse-free survival (30 vs 19 months, p<0.0001) and overall survival (36 vs 27 months, p<0.01) [11]. Following these results, postoperative radio-chemotherapy according to the Macdonald protocol became the new standard of care [11]. However, much concern remains regarding the toxicity of the regimen. 41% of patients had grade 3 digestive toxicity and 32% grade 4 [11]. The objective of our AbstractBackground: Several studies have shown that surgery alone is not enough in the management of early gastric cancer with locoregional relapse in 40% to 60%. The frequency of relapses makes regional radiotherapy an attractive possibility for adjuvant therapy. The survival benefit of adjuvant chemoradiation over surgery alone was first established by the US Intergroup 0116 study.

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The Prognostic Significance of an R1 Resection in Gastric Cancer Patients Treated with Adjuvant Chemoradiotherapy

Abstract: A R1 resection was not an adverse prognostic factor in gastric cancer patients who had undergone CRT after the operation.

Cited by 42 publications

References 29 publications

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

S3-Leitlinie Magenkarzinom – Diagnostik und Therapie der Adenokarzinome des Magens und des ösophagogastralen Übergangs – Langversion 2.0 – August 2019. AWMF-Registernummer: 032/009OL

Adjuvant Chemoradiation for Localized Gastric Adenocarcinoma: An Institutional Experience

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