GASTRIC CANCER

  • Franc Jelenc Klinični oddelek za abdominalno kirurgijo Kirurška klinika Klinični center Zaloška 7 1525 Ljubljana
Keywords: gastric cancer, prognostic factors, multidisciplinary approach

Abstract

Background. In contrast to the incidence of esophageal cancer, the incidence of gastric cancer is decreasing in our country and worldwide. The location of gastric tumors is shifting from the distal portion of the stomach to the proximal stomach and the gastric cardia. Despite advances in surgical therapy for gastric cancer, the overall prognosis of patients with this disease has not improved markedly the past decades because, these tumors continue to be diagnosed at an advanced stage. Systemic and local recurrences are common even after complete tumor resection and extensive lymphadenectomy. Multidisciplinary approaches with adjuvant and neoadjuvant chemotherapy, radiotherapy, or combined radiochemotherapy is the focus of many studies. The problem is in study design, to stratified patients according to tumor location, extent of tumor, type of resection, extent of lymphadenectomy, and experience of the surgeon or institution performing the resection. Each of these factors may independently influence to prognosis of the disease.

Conclusions. The most important prognostic factors in the surgical treatment of gastric cancer and the principles of the treatment of gastric cancer are presented in this article.The results of the surgical treatment of gastric cancer from different surgical departements of Slovenian hospitals are described.The number of the patients with gastric cancer have dicreased in the past seven years. A significant improvement in the early postoperative results was not observed in the same period.

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References

Union Internationale Contre le Cancer: TNM cassification of malignant tumors. New York: Springer, 1997.

Stein HJ, Sendler A, Fink U, Siewert JR. Multidisciplinary approach to cancer. Multidisciplinary approach to esophageal and gastric cancer. Surg Clin North Am 2000; 80: 659–82.

Siewert JR, Bottcher K, Stein HJ, German Gastric Study Group. Relevant prognostic factors in gastric cancer. Ten-year results of the German Gastric Cancer Study. Ann Surg 1998; 228: 449–61.

Karpeh MS, Leon L, Klimstra D, Brennan MF. Lymph node staging in gastric cancer: is location more important than number? Ann Surg 2000; 232: 362– 71.

Burke EC, Karpeh MS, Conlon KC. Peritoneal lavage cytology in gastric cancer: an independent predictor of outcome. Ann Surg Oncol 1998; 5: 411–5.

Dittler HJ, Siewert JR. Role of endoscopic ultrasonography in gastric carcinoma. Endoscopy 1993; 25: 162–6.

Pratt BL. Rile of laparoscopy in the staging of malignant disease. Surg Clin North Am 2000; 80: 1111–26.

Gall FP. Histologie und stadiengerechte Chirurgie beim Magenkarzinom. In: Gall FP, Hermanek P, Hornig P. Magenkarzinom. Epidemiologie, Pathologie, Therapie, Nachsorge. Muenchen: Zuckswerdt, 1986: 80–6.

Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. Acta Path Microbiol Scand 1965; 64: 31– 49.

Bonenkamp JJ, Songun I, Hermans J et al. Randomized comparison of morbidity after D1 and D2 disection for gastric cancer in 996 Dutch patients. Lancet 1995; 345: 745–8.

Griffith JP, Sue-Ling HM, Martin I. Preservation of the spleen improves survival after radical surgery for gastric cancer. Gut 1995; 36: 684–90.

Kitamura K, Nishida S, Ichikawa D et al. No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer. Br J Surg 1999; 86: 119–22.

Oghami M, Otani Y, Kumai K. Curative laparoscopic surgery for early gastric cancer: five year experience. World J Surg 1999; 23: 187–93.

Hermans J, Bonenkamp JJ, Boon MC. Adjuvant therapy after curative resection for gastric cancer: meta-analysis of randomised trials. J Clin Oncol 1993; 18: 1441–7.

Mari E, Floriani I, Tinazzi A et al. Efficasy of adjuvant chemotherapy after curative resection for gastric cancer: a metaanalysis of published randomized trials. A study of the GISCAD. Ann Oncol 2000; 11: 837–43.

Hallisey MT, Dunn JA, Ward LC et al. The second British Stomach Cancer Group trial of adjuvant radiotherapy or chemotherapy in resectable gastric cancer: five-year follow-up. Lancet 1994; 343: 1309–12.

Sun W, Haller DG. Recent advances in the treatment of gastric cancer. Drugs 2001; 61: 1545–51.

Yu W, Whang I, Suh I, Averbach A, Chang D, Sugarbaker PH. Prospective randomized trial of early postoperative intraperitoneal chemotherapy as an adjuvant to resectable gastric cancer. Ann Surg 1998; 228: 347–54.

Newman E. Neoadjuvant chemotherapy with CPT-11 and cisplatin downstages locally advanced gastric cancer. J Gastrointest Surg 2002; 6: 212–23.

Ajani JA. Is neoadjuvant therapy for locally advanced stomach carcinoma standard? Chirurg 2002; 73: 321–5.

Fink U, Stein HJ, Schumacher C. Neoadjuvant chemotherapy for gastric cancer. Update. World J Surg 1995; 19: 509–16.

Wilke H, Preusser F, Fink U et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: A phase II study with etoposide, doxorubucin and cisplatin. J Clin Oncol 1998; 7: 1318–26.

Lowy AM, Mansfield PF, Leach SD et al. Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer. Ann Surg 1999; 229: 303–8.

Boku N, Ohsushi A, Shimuda Y et al. Phase II study of a combination of irinotecan and cisplatin against metastatic gastric cancer. J Clin Oncol 1999, 17: 319–23.

Ajani JA, Fodor M, Cutsem EV et al. Multinatuonal randomized phase II trial of docetaxel (T) and cisplatin (C) with or without 5-fluorouracil and leukovorin (LVC) in patients with advanced agstric or GE junction adenocarcinoma. Proc Am Soc Clin Oncol 2000; 19: A 957–7.

How to Cite
1.
Jelenc F. GASTRIC CANCER. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];72. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1916
Section
Review