Multimodality approaches to localized gastric cancer.
Most patients with localized gastric cancer require multimodality therapy. Surgery is the primary treatment for localized gastric cancer, although controversy exists about the optimal extent of lymphadenectomy in these patients. Recent studies have evaluated the role of laparoscopic surgery and endoscopic mucosal resection in selected patients. Multimodality treatment options for these patients include post-operative chemoradiation and perioperative chemotherapy. The Intergroup 0116 trial demonstrated that patients treated with surgery and post-operative chemoradiation had significantly higher overall survival compared to patients treated with surgery alone. The MAGIC trial showed that patients treated with perioperative epirubicin, cisplatin, and 5-fluorouracil had significantly higher overall survival compared to patients treated with surgery alone. Other recent trials have evaluated the roles of preoperative chemoradiation and adjuvant chemotherapy. Multidisciplinary evaluation plays a crucial role in the management of these patients.
Das
Prajnan
P
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas77030, USA. PrajDas@mdanderson.org
Jiang
Yixing
Y
Lee
Jeffrey H
JH
Bhutani
Manoop S
MS
Ross
William A
WA
Mansfield
Paul F
PF
Ajani
Jaffer A
JA
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005743:Gastrectomy; D006801:Humans; D020360:Neoadjuvant Therapy; D011879:Radiotherapy Dosage; D013274:Stomach Neoplasms / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
D000970:Antineoplastic Agents