Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial

Sasako, Mitsuru; Sano, Takeshi; Yamamoto, Seiichiro; Sairenji, Motonori; Arai, Kuniyoshi; Kinoshita, Taira; Nashimoto, Atsushi; Hiratsuka, Masahiro

doi:10.1016/s1470-2045(06)70766-5

Cited by 406 publications

(335 citation statements)

References 19 publications

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“…Although surgery is the standard treatment for resectable gastric cancer [2,3], the prognosis of patients with advanced tumors is poor [4]. In particular, linitis plastica (Borrmann type 4) and large ulcero-invasive-type (Borrmann type 3) tumors, as well as those with paraaortic nodal metastases or bulky lymph node metastases, have extremely poor outcomes even after curative resection [5,6].…”

Section: Introductionmentioning

confidence: 99%

Validity of response assessment criteria in neoadjuvant chemotherapy for gastric cancer (JCOG0507-A)

et al. 2013

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Background Neoadjuvant chemotherapy may improve outcomes in gastric cancer. Tumor responses can be evaluated with RECIST, Japanese Classification of Gastric Carcinoma (JCGC), and histological criteria. These approaches have not yet been compared. Methods We analyzed two phase II trials of neoadjuvant chemotherapy using S-1 plus cisplatin. JCOG0210 included patients with linitis plastica and large ulcero-invasive tumors, whereas JCOG0405 comprised those with paraaortic or bulky lymph node metastases. Radiologic evaluations were conducted using RECIST in JCOG0405 and JCGC criteria in JCOG0210, because the latter included many patients without measurable lesions. A histological responder was defined as a patient in whom one third or more of the tumor was affected. The hazard ratios (HR) for death between responders and non-responders and response rate differences between short-and long-term survivors were estimated. Results In JCOG0210 (n = 49), HR was 0.54 in JCGC responders (P = 0.059) and 0.40 in histological responders (P = 0.005). The difference in response rates between short-and long-term survivors using histological criteria (34 %, P = 0.023) was greater than that using JCGC criteria (24 %, P = 0.15). In JCOG0405 (n = 51), HR was 0.67 in RECIST responders (P = 0.35) and 0.39 in histological responders (P = 0.030). In short-and long-term survivors, respectively, RECIST response rates were 62 and 67 % (P = 0.77), whereas histological response rates were 33 and 63 % (P = 0.048). Conclusions Histological criteria showed higher response assessment validity than RECIST or JCGC criteria and yielded the best surrogate endpoint for overall survival.

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Section: Introductionmentioning

confidence: 99%

Validity of response assessment criteria in neoadjuvant chemotherapy for gastric cancer (JCOG0507-A)

et al. 2013

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“…Difficulties in surgical management and an unfavorable prognosis with 5-year survival rates of 30-50 % make this disease a malignancy of great universal concern [4,5,[10][11][12]. The subclassification of GEJ carcinoma provides a useful tool for the selection of the appropriate surgical procedure [4].…”

Section: Introductionmentioning

confidence: 99%

“…With respect to the procedure of choice for type II carcinoma, there has been some debate whether a transthoracic subtotal esophagectomy, as in type I tumors, or a total gastrectomy with transhiatal resection of the distal esophagus, as in type III tumors, is optimal. However, two recent phase III trials [11,12] demonstrated the transhiatal approach to be preferable.…”

Section: Introductionmentioning

confidence: 99%

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

et al. 2012

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Background It remains uncertain whether radical lymphadenectomy combined with total gastrectomy actually contributes to long-term survival for Siewert type II adenocarcinoma of the cardia. We identified the pattern of abdominal nodal spread in advanced type II adenocarcinoma and defined the optimal extent of abdominal lymphadenectomy. Methods Eighty-six patients undergoing R0 total gastrectomy for advanced type II adenocarcinoma were identified from the gastric cancer database of 4,884 patients. Prognostic factors were investigated by multivariate analysis. The therapeutic value of lymph node dissection for each station was estimated by multiplying the incidence of were considered not beneficial to dissect, whereas there were substantial therapeutic benefits to dissecting the perigastric nodes of the upper half of the stomach in positions 1-3 and the second-tier nodes in positions 7 and 11. Conclusions Limited lymphadenectomy attained by proximal gastrectomy might suffice as an alternative to extended lymphadenectomy with total gastrectomy for obtaining On behalf

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“…Sasako et al 23. demonstrated that there was no benefit in terms of long‐term survival when using the left thoracoabdominal approach for gastric cancers of the cardia and subcardia (which allows better access to the mediastinal nodes) compared to the abdominal‐transhiatal approach, but that the former was associated with increased morbidity.…”

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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Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial

Cited by 406 publications

References 19 publications

Validity of response assessment criteria in neoadjuvant chemotherapy for gastric cancer (JCOG0507-A)

Validity of response assessment criteria in neoadjuvant chemotherapy for gastric cancer (JCOG0507-A)

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

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

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