Review article
https://doi.org/10.20471/LO.2021.49.02-03.14
Perioperative treatment of gastric cancer- short review
Josipa Flam
orcid.org/0000-0003-1351-7511
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia;Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Luka Perić
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia;Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Mirela Šambić-Penc
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia;Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Maja Kovač-Barić
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia
Darko Kotromanović
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia;Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Nora Pušeljić
; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia;Emergency medicine, University Hospital Center Osijek, Osijek, Croatia
Ivana Canjko
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia
Abstract
Adenocarcinoma of the gastroesophageal junction (GEJ) and gastric cancer have poor outcomes in most patients.
Perioperative chemotherapy became a standard of care for resectable adenocarcinoma of the upper GI tract based on the results of the MAGIC trial. The study includes patients with Stage II or III resectable adenocarcinoma of the stomach, GEJ, and lower esophagus. The ACCORD trial essentially supported the results of the MAGIC study.
Both studies showed that preoperative chemotherapy could induce downstaging and enhance the possibility of potentially curative R0 resection, thus increasing the probability of disease-free survival and overall survival.
The NeoFLOT study investigates the application of prolonged neoadjuvant chemotherapy (NACT). This study indicates that NACT with six cycles of FLOT is highly effective in resectable gastroesophageal cancer. The CRITICS trial compares perioperative chemotherapy with preoperative and postoperative chemoradiotherapy in patients with resectable gastric adenocarcinoma. Postoperative chemoradiotherapy did not improve overall survival compared with postoperative chemotherapy in patients with resectable gastric cancer treated with adequate preoperative chemotherapy and surgery.
In recent years, guidelines for the treatment of gastric cancer have changed frequently. Because gastric cancer treatment is complex and perioperative chemotherapy is present in all treatment guidelines, a multidisciplinary team with experienced physicians is the foundation of effective gastric cancer treatment.
Keywords
stomach neoplasms; chemoradiotherapy; neoadjuvant chemotherapy
Hrčak ID:
267954
URI
Publication date:
22.12.2021.
Visits: 1.856 *