title: [Resection of advanced esophagogastric adenocarcinoma : Extended indications].
abstract: In the current German S3 guidelines surgical treatment is not recommended for metastatic gastric cancer or metastatic adenocarcinoma of the esophagogastric junction; however, in routine practice the indications can be extended so that there may be occasions in which radical surgical intervention for specific individuals may be appropriate as part of a multimodal therapy with curative intent. This article presents the scientific rationale of such an approach based on the available literature considering modern, multimodal therapy concepts including criteria to be met for radical surgery. Currently only retrospective trials and limited current meta-analysis data are available for justifying surgical treatment for metastatic adenocarcinoma. The recently published initial results of the FLOT-3 study identified a patient subgroup that benefits from a resection even though metastasis has occurred. Whether surgical therapy will become an integral part of the treatment of limited metastatic adenocarcinoma of the stomach and esophagus in the future, has to be demonstrated by large prospective randomized studies, such as the RENAISSANCE/FLOT-5 study.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland. stefan.moenig@uk-koeln.de.|Service de Chirurgie viscéral, Hôpitaux Universitaires de Genève, Rue Gabrielle Perret-Gentil 4, CH-1211, Genève, Switzerland. stefan.moenig@uk-koeln.de.
authors.forename: S P
authors.initials: SP
authors.lastname: Mönig
authors.affiliation: Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
authors.forename: L M
authors.initials: LM
authors.lastname: Schiffmann
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005743:Gastrectomy; D019983:Guideline Adherence; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D059146:Metastasectomy; D009367:Neoplasm Staging; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate
keywords: Adenocarcinoma esophagogastric junction; Gastric carcinoma; Guidelines; Metastasectomy; Metastasis