title: Highlights of the EORTC St. Gallen International Expert Consensus on the primary therapy of gastric, gastroesophageal and oesophageal cancer - differential treatment strategies for subtypes of early gastroesophageal cancer.
abstract: The 1st St. Gallen EORTC Gastrointestinal Cancer Conference 2012 Expert Panel clearly differentiated treatment and staging recommendations for the various gastroesophageal cancers. For locally advanced gastric cancer (≥T3N+), the preferred treatment modality was pre- and postoperative chemotherapy. The majority of panel members would also treat T2N+ or even T2N0 tumours with a similar approach mainly because pretherapeutic staging was considered highly unreliable. It was agreed that adenocarcinoma of the gastroesophageal junction (AEG) is classified best according to Siewert et al. Preoperative radiochemotherapy (RCT) is the preferred treatment for AEG type I and II tumours. For AEG type III, i.e. tumours which may be considered as gastric cancer, perioperative chemotherapy is the majority approach. For resectable squamous cell cancer of the oesophagus a clear majority recommended radiochemotherapy followed by surgery as optimal approach, irrespective of tumour size. In contrast, definitive RCT was judged appropriate for advanced tumours with extended lymph node involvement (N2) or for cancers of the upper oesophagus. Additional recommendations are presented on the use of endosonography, PET-CT scan and laparoscopy for staging and on the preferred approach to surgery.
authors.affiliation: CaritasKlinikum St. Theresia, Saarbrücken, Germany. m.lutz@caritasklinikum.de
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Lutz
authors.forename: John R
authors.initials: JR
authors.lastname: Zalcberg
authors.forename: Michel
authors.initials: M
authors.lastname: Ducreux
authors.forename: Jaffer A
authors.initials: JA
authors.lastname: Ajani
authors.forename: William
authors.initials: W
authors.lastname: Allum
authors.forename: Daniela
authors.initials: D
authors.lastname: Aust
authors.forename: Yung-Jue
authors.initials: YJ
authors.lastname: Bang
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
authors.forename: Arnulf
authors.initials: A
authors.lastname: Hölscher
authors.forename: Janusz
authors.initials: J
authors.lastname: Jankowski
authors.forename: Edwin P M
authors.initials: EP
authors.lastname: Jansen
authors.forename: Ralf
authors.initials: R
authors.lastname: Kisslich
authors.forename: Florian
authors.initials: F
authors.lastname: Lordick
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariette
authors.forename: Markus
authors.initials: M
authors.lastname: Moehler
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Oyama
authors.forename: Arnaud
authors.initials: A
authors.lastname: Roth
authors.forename: Josef
authors.initials: J
authors.lastname: Rueschoff
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruhstaller
authors.forename: Raquel
authors.initials: R
authors.lastname: Seruca
authors.forename: Michael
authors.initials: M
authors.lastname: Stahl
authors.forename: Florian
authors.initials: F
authors.lastname: Sterzing
authors.forename: Eric
authors.initials: E
authors.lastname: van Cutsem
authors.forename: Ate
authors.initials: A
authors.lastname: van der Gaast
authors.forename: Jan
authors.initials: J
authors.lastname: van Lanschot
authors.forename: Marc
authors.initials: M
authors.lastname: Ychou
authors.forename: Florian
authors.initials: F
authors.lastname: Otto
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D055088:Early Detection of Cancer; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016629:Esophagectomy; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery*; D005743:Gastrectomy; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome