Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial

Fujitani, Kazumasa; Yang, Han–Kwang; Mizusawa, Junki; Kim, Young Woo; Terashima, Masanori; Han, Sang‐Uk; Iwasaki, Yoshiaki; Hyung, Woo Jin; Takagane, Akinori; Park, Do Joong; Yoshikawa, Takaki; Hahn, Seokyung; Nakamura, Kenichi; Park, Cho Hyun; Kurokawa, Yukinori; Bang, Yung‐Jue; Park, Byung Joo; Sasako, Mitsuru; Tsujinaka, Toshimasa

doi:10.1016/s1470-2045(15)00553-7

Cited by 589 publications

(530 citation statements)

References 27 publications

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“…This was followed by the demonstration of cisplatin being beneficial on top of S‐1 as first‐line treatment for advanced and unresectable gastric cancer 34. Fujitani et al 35. were the first to properly address the issue for performing gastrectomy on top of chemotherapy in patients with incurable gastric cancer through a high quality randomized control trial.…”

Section: Gastric Surgerymentioning

confidence: 99%

Gastroenterological surgery in Japan: The past, the present and the future

Colvin

Mizushima

Eguchi

et al. 2017

Annals of Gastroent Surgery

138

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In the last two centuries, there has been remarkable progress in the field of gastroenterological surgery, including the curative resection of cancers, replacement of failed organs through transplantation, increased safety of undergoing major surgeries and decreased operative morbidity through developments in minimal access surgery. Japan has very much been at the forefront of these advances, as is evident from the present review, from advancing the surgical management of gastric cancer to the pioneering work in live‐donor transplantation. This review also highlights many instances where surgical management of the same pathologies has evolved differently between Japan and the West. It is encouraging that many procedures established in Japan are eventually taken up by the West, often after rigorous assessment affirming the quality and applicability of such techniques. In Japan, many of the crucial issues in gastroenterological surgery are increasingly addressed through large multi‐institutional prospective control trials, ensuring that Japanese surgeons continue to contribute to the advances in gastroenterological surgery.

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Section: Gastric Surgerymentioning

confidence: 99%

Gastroenterological surgery in Japan: The past, the present and the future

Colvin

Mizushima

Eguchi

et al. 2017

Annals of Gastroent Surgery

138

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“…Recently, a randomized controlled trial (JCOG 0705) was conducted on patients with stage IV gastric cancer with a single non-curable factor [18]. However, the study could not demonstrate any benefit of palliative surgery when compared with systemic chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Survival analysis of patients with stage IV gastric cancer following palliative surgery based on inflammation-based prognostic score

Matsubara¹,

Hirahara²,

Takanashi³

et al. 2017

Gastroenterol Hepatol Endosc

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Objective: The Glasgow Prognostic Score (GPS) has been demonstrated to be a useful prognostic factor for various tumors. The aim of the current study was to clarify the significance of the GPS for predicting postoperative survival of patients with stage IV gastric cancer after receiving palliative surgery. Summary of background data:Generally stage IV gastric cancer is not considered for curative surgery. However, palliative surgery is often required to improve the quality of life of patients.Methods: 51 consecutive patients with stage IV gastric cancer was performed the association between GPS, clinicopathological factors and overall survival was assessed.Results: Peritoneal lavage cytology (CY), P0CY1 (no peritoneal dissemination and CY positive), surgical treatment, operative time and curability factors were correlated well with the GPS score. The number of metastatic sites (1 vs. ≧2), curability (R0, R1 vs. R2) and GPS score (0, 1 vs. 2) were found to be the independent prognostic factor. The prognosis of patients with a high GPS was significantly poor. Conclusion:In patients with a GPS of 2, surgical treatment offered only few benefits to the patients and, thus, less invasive treatment should be recommended for these patients.

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“…Survival benefit of palliative resection prior to chemotherapy has been denied in a population of patients with unresectable distant metastases, including those with macroscopically evident peritoneal deposits 59. Intraperitoneal chemotherapy could achieve complete response in some patients with peritoneal deposits so that initially unresectable patients could become candidates for R0 resection and receive what has been referred to in this article as conversion surgery.…”

Section: Peritoneal Metastasismentioning

confidence: 99%

Surgery with curative intent for stage IV gastric cancer: Is it a reality of illusion?

Kodera

2018

Annals of Gastroent Surgery

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Gastric cancer with metastases outside of the regional lymph nodes is deemed oncologically unresectable. Nevertheless, some metastatic lesions are technically resectable by applying established surgical techniques such as para‐aortic lymphadenectomy and hepatectomy. At the time of compilation of the Japanese gastric cancer treatment guidelines version 4, systematic reviews were conducted to see whether it is feasible to make any recommendation to dissect both the primary and metastatic lesions with intent to cure, possibly as part of multimodality treatment. Long‐term survivors were found among carefully selected groups of patients both in prospective and retrospective studies. In addition, there is a growing list of publications reporting encouraging outcomes of gastrectomy conducted after exceptionally good response to chemotherapy, usually among patients who underwent R0 resection. This type of surgery is often referred to as conversion surgery. It is sometimes difficult to define a clear borderline between curative surgery scheduled after neoadjuvant chemotherapy and the conversion surgery. This review summarizes what we knew after the literature reviews conducted at the time of compiling the Japanese guidelines and in addition reflects some new findings obtained thereafter through clinical trials and retrospective studies. Metastases were divided into three categories based on the major metastatic pathways: lymphatic, hematogenous, and peritoneal. In each of these categories, there were findings that could provide hope for patients with metastatic disease. These findings implied that the surgical technique that we already use could become more useful upon further developments in antineoplastic agents and drug delivery.

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Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial

Cited by 589 publications

References 27 publications

Gastroenterological surgery in Japan: The past, the present and the future

Gastroenterological surgery in Japan: The past, the present and the future

Survival analysis of patients with stage IV gastric cancer following palliative surgery based on inflammation-based prognostic score

Surgery with curative intent for stage IV gastric cancer: Is it a reality of illusion?

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