European validation of the Yonsei Gastric Cancer Prognosis Prediction Model after gastrectomy: Validation with the Netherlands Cancer Registry
This study aimed to validate this model in a European cohort.MethodsAll patients who underwent gastrectomy for gastric cancer were selected from the Netherlands Cancer Registry (2005–2015). Patients with 30-day mortality, co-existing cancer, neoadjuvant therapy, or missing data were excluded. The prediction model included gender, age, resection type, pT-stage, pM-stage, number of retrieved lymph nodes, number of metastatic lymph nodes, and tumor histology. The model was validated and compared to the 7th TNM staging system using calibration plots and the concordance index (c-statistic with 95% confidence interval (CI)).ResultsFrom the 5748 patients who underwent gastrectomy, 2253 were included in this study. Mean age was 72.1 years, most patients had advanced gastric cancer (88%), and in 1102 patients (49%) no proper TNM staging could be performed since
Conclusion: Conversion surgery, including extended gastrectomy and multi-organ resections followed by HIPEC performed after systemic chemotherapy therapy for GC with PM is justified in downstaged patients with ypT2 and limited (less than P3) PM.
AbstractThe standard treatment for locally advanced gastric cancer differs across the world. In western countries, perioperative chemotherapy or postoperative adjuvant chemoradiotherapy are the preferred treatment options, whereas in Asia, D2 gastrectomy followed by postoperative adjuvant chemotherapy is standard. In Japan, adjuvant chemotherapy with S-1 is the standard treatment for pStage II gastric cancer, whereas adjuvant chemotherapy with a doublet regimen is preferred for pStage III gastric cancer. The efficacy of preoperative neoadjuvant chemotherapy using S-1 plus cisplatin, has been investigated in selected patien...
Laparoscopy-assisted distal gastrectomy offered better short-term, post-surgical outcomes for patients with locally advanced gastric cancer who were undergoing neoadjuvant chemotherapy.
In patients with locally advanced gastric cancer, laparoscopy-assisted distal gastrectomy (LADG) after neoadjuvant chemotherapy appears to offer more short-term benefits than does open gastrectomy, according to Chinese researchers.Reuters Health Information
CONCLUSION: Perioperative CapeOx showed good feasibility and favorable efficacy with sufficient pathological response, although statistical significance at .058 did not reach the commonly accepted cutoff of .05. The data obtained using this novel approach warrant further investigations. PMID: 31570518 [PubMed - as supplied by publisher]
In this study, an open-label, single cente r, phase 2 randomized clinical trial with a noninferiority design, the authors assessed outcomes at 3 years. All patients received neoadjuvant therapy of oxaliplatin and capecitabine before their operation. Li and colleagues reported significantly lower postoperative complication rates, less postope rative pain, and better adherence to and completion of adjuvant therapy among trial participants.
To demonstrate that post-therapy pathological tumor volume (ypTV) should be considered as an independent prognostic factor in advanced gastric cancer (GC) patients who underwent neoadjuvant chemotherapy (NAC) ...
This article reviews the history of surgical EGJ cancer treatment and current surgical strategies from a Western perspective. PMID: 31245158 [PubMed]
Conclusions: Most endoscopic responders showed JCGC histological responses. Evaluation of neoadjuvant chemotherapeutic efficacy by endoscopy in gastric cancer may be useful before gastrectomy. As this was a retrospective study, further investigations are required. The protocol was approved by the ethics review committee at Osaka Medical College (No. 2422) and was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000033088).Digestion
Conclusion: PGC and DGC differed in their clinicopathologic characteristics and prognosis and heterogeneity may be due to differences in tumor biology. Tumor location should be taken into consideration when stratifying patients for optimal therapeutic strategies.