The Perioperative and Operative Management of Esophageal and Gastric Cancer

Siddiqi, Amn; Johnston, Fabian M.

doi:10.1016/j.soc.2022.07.006

Cited by 5 publications

(2 citation statements)

References 96 publications

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“…Neoadjuvant therapy has been part of the treatment for patients with advanced gastric, GEJ and oesophageal tumours for more than two decades now. Its justification is unquestionable, and any change in the treatment methods has a considerable impact also on surgery, among others ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of neoadjuvant FLOT treatment of advanced gastric and gastroesophageal junction cancer following surgical therapy

et al. 2023

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IntroductionTherapeutic treatment for advanced-stage (T2–T4) gastroesophageal junction (GEJ) and gastric cancer involves neoadjuvant chemotherapy with subsequent surgical intervention.MethodNeoadjuvant oncological treatment for GEJ and gastric cancer previously consisted of the intravenous administration of epirubicin, cisplatin and fluorouracil (ECF) or epirubicin, cisplatin and capecitabine (ECX) combination (Group 1). The new protocol (FLOT, F: 5-FU, L: leucovorin, O: oxaliplatin, T: docetaxel), included patients with resectable GEJ and gastric cancer who had a clinical stage cT2 or higher nodal positive cN+ disease (Group 2). Between 31 December 2008 and 31 October 2022, the effect of different oncological protocols in terms of surgical outcomes in cases of T2–T4 tumours were retrospectively evaluated. Results of randomly assigned patients from the earlier ECF/ECX protocol (n = 36) (Group 1) and the new FLOT protocol (n = 52) (Group 2) were compared. Effect of different neoadjuvant therapies on tumour regression, types of possible side effects, type of surgery, and oncological radicality of surgical procedures were analysed.ResultsWhen comparing the two groups, we found that in case of the FLOT neoadjuvant chemotherapy (Group 2, n = 52), complete regression was achieved in 13.95% of patients, whereas in the case of ECF/ECX (Group 1, n = 36), complete regression occurred in only 9.10% of patients. Furthermore, in the FLOT group, the mean number of lymph nodes removed was slightly higher (24.69 vs. 20.13 in the ECF/ECX group). In terms of the safety resection margin (proximal), no significant difference was found between the two treatment groups. Nausea and vomiting were the most common side effects. The occurrence of diarrhea was significantly higher in the FLOT group (p = 0.006). Leukopenia and nausea occurred more commonly with the old protocol (Group 1). The rate of neutropenia was lower following FLOT treatment (p = 0.294), with the lack of grade II and III cases. Anaemia occured at a significantly higher rate (p = 0.036) after the ECF/ECX protocol.ConclusionsAs a result of the FLOT neoadjuvant oncological protocol for advanced gastro-esophageal junction and gastric cancer, the rate of complete tumour regression increased significantly. The rate of side effects was also appreciably lower following the FLOT protocol. These results strongly suggest a significant advantage of the FLOT neoadjuvant treatment used before surgery.

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Section: Discussionmentioning

confidence: 99%

Impact of neoadjuvant FLOT treatment of advanced gastric and gastroesophageal junction cancer following surgical therapy

et al. 2023

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“…At time of diagnosis, only 18% of patients have localized disease, 32% regional, 40% distant, with 5‐year survival decreasing dramatically from 47% in localized disease, to 25% in regional, and to 5% in distant disease (Table 1). 4–7 The past 40 years in the United States has seen improvement in 5‐year survival from about 5% in the 1970s to about 20% in the 2010s (all stages) (Figure 1). 4 This slow but steady progress stemmed from advances in earlier diagnosis, innovations in surgical technique and technology, improvement in critical care, and advancement in understanding the role of chemotherapy and radiotherapy through clinical trials.…”

Section: Introductionmentioning

confidence: 99%

New molecular and immunologic targets of therapy for esophageal cancer and the prospects for ongoing and future clinical trials

Dhanasopon

2023

Journal of Surgical Oncology

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Esophageal cancer is a deadly disease worldwide. Advancements in diagnosis, surgical technique, chemotherapy, and radiotherapy have improved survival over the years. While targeted therapy and immunotherapy have significantly impacted survival for patients with advanced disease, they have also been demonstrating efficacy when added to trimodality therapy for locoregional disease. This review focuses on molecular and immunologic targets of therapy for esophageal cancer and the prospects for ongoing and future clinical trials.

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Controlled synthesis of zinc oxide nanoparticles through flame spray pyrolysis and evaluation of their anticancer effects against gastric cancer cell

Du¹,

Feng²,

Li³

et al. 2023

Arabian Journal of Chemistry

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The Perioperative and Operative Management of Esophageal and Gastric Cancer

Cited by 5 publications

References 96 publications

Impact of neoadjuvant FLOT treatment of advanced gastric and gastroesophageal junction cancer following surgical therapy

Impact of neoadjuvant FLOT treatment of advanced gastric and gastroesophageal junction cancer following surgical therapy

New molecular and immunologic targets of therapy for esophageal cancer and the prospects for ongoing and future clinical trials

Controlled synthesis of zinc oxide nanoparticles through flame spray pyrolysis and evaluation of their anticancer effects against gastric cancer cell

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