Is surgery alone sufficient for treating T1 gastric cancer with extensive lymph node metastases?

AbstractBackgroundWhether or not surgery alone is sufficient for treating patients with pathological stage T1N2M0 (Stage IIA), T1N3a/bM0 (Stage IIB/IIIB), and T3N0M0 (Stage IIA) gastric cancer who were not indicated for adjuvant treatment according to the Japanese gastric cancer treatment guideline remains unclear.MethodsWe retrospectively reviewed the clinical records of 236 patients who had been diagnosed with pT1N2-3b/pT3N0 gastric cancer and undergone R0 gastrectomy with lymph node dissection between January 2000 and December 2012 at the National Cancer Center Hospital, Japan.ResultsThe 5-year recurrence-free survival (RFS) rates (95% confidence interval [CI]) of the patients with pathological (p) T1N2-3b and T3N0 cancer were 73.9% (63.1 –84.7) and 89.5% (84.0–95.0), respectively. The only significant prognostic factors for the survival identified by a multivariate Cox regression analysis in patients with pT1N2-3 cancer were the pN stage (N3a/N2: hazard ratio [HR] 2.940, 95% CI 1.314–5.577; N3b/N2: HR 8.688, 95% CI 3.096–24. 382) and tumor diameter (
Source: Gastric Cancer - Category: Gastroenterology Source Type: research

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Conclusion.These findings suggest that combination therapy with capecitabine and oxaliplatin as perioperative chemotherapy, followed by D2 gastrectomy, is effective and safe in late‐stage, locally advanced gastric cancer. Although enrollment exceeded the 47 patients required to identify an increase in the ORR by 15% (from 40% to 55%), results did not meet the primary endpoint.
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Chinese Edition, Clinical Trial Results, Gastrointestinal Cancer Source Type: research
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...
Source: Surgery Today - Category: Surgery Source Type: research
Purpose of review The aim of this study was to review studies published within the past year regarding management of gastric cancer. Recent findings Laparoscopic gastrectomy achieves equivalent survival compared with open gastrectomy in early stage and locally advanced gastric cancer. Adjuvant chemotherapy with 6 months of S-1 and oxaliplatin was superior to 12 months of S-1, and the addition of postoperative radiation therapy did not improve survival. The FLOT regimen is the new standard for preoperative chemotherapy. In metastatic gastric cancer, the addition of docetaxel to S-1 and cisplatin failed to improve overa...
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research
Laparoscopy-assisted distal gastrectomy offered better short-term, post-surgical outcomes for patients with locally advanced gastric cancer who were undergoing neoadjuvant chemotherapy.  
Source: CancerNetwork - Category: Cancer & Oncology Authors: Source Type: news
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
Source: Medscape Gastroenterology Headlines - Category: Gastroenterology Tags: Hematology-Oncology News Source Type: news
ConclusionsAmong stage IB/IIA gastric cancer patients that underwent gastrectomy with curative-intent, post-operative adjuvant chemotherapy may be considered for patients carrying the TP53 codon 72 Pro/Pro polymorphism.Clinical trial identificationNCT01905969.Editorial acknowledgementChristopher Brooks of Bioscience Editing Solutions.Legal entity responsible for the studyThe authors.FundingMinistry of Education, Culture, Sports, Science and Technology, Japan.DisclosureY. Ohmori: Full / Part-time employment: Astellas Pharma Inc.
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
This randomized clinical trial examines the safety and advantages of laparoscopy-assisted distal gastrectomy over the traditional open gastrectomy and following chemotherapy for adults with gastric adenocarcinoma.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
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.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
This study aimed to identify the risk factors for NAFLD after gastrectomy for gastric cancer.MethodsA total of 721 patients who underwent gastrectomy for gastric cancer and plane abdominal computed tomography (CT) preoperatively and 1 year after surgery were included in this study. NAFLD was defined as having a mean hepatic CT attenuation value of  
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
Publication date: Available online 20 September 2019Source: Cirugía Española (English Edition)Author(s): Vicente Munitiz, Angeles Ortiz, David Ruiz de Angulo, Luisa F. Martinez de Haro, Pascual ParrillaAbstractThere is significant controversy in the management of cardiac cancer. It seems unanimous that Siewert type I tumors be operated on as cancer of the esophagus and Siewert type III as gastric cancer. However, for “true” cancer of the gastric cardia or Siewert II, the authors do not agree. There is the obvious need for free proximal and distal margins, as well as correct lymphadenectomy. For so...
Source: Cirugia Espanola - Category: Surgery Source Type: research
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