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Multidisciplinary management of gastric and gastroesophageal cancers

查看全文 作  者:Markus [1]Moehler;Orestis [2]Lyros;Ines [2]Gockel;Peter R [1]Galle;Hauke [2]Lang 高影响力作者 机构地区:[1]First Department of Internal Medicine of Johannes Gutenberg University of Mainz;[2]Institute of Surgery of Johannes Gutenberg University of Mainz高影响力机构 出  处:《World Journal of Gastroenterology》索引2008年第14卷第24期,共8页高影响力期刊 摘  要:Carcinomas of the stomach and gastroesophageal junction are among the fi ve top leading cancer types worldwide. In spite of radical surgical R0 resections being the basis of cure of gastric cancer,surgery alone provides long-term survival in only 30% of patients with advanced International Union Against Cancer (UICC) stages in Western countries because of the high risk of recurrence and metachronous metastases. However,recent large phase-Ⅲ Studies improved the diagnostic and therapeutic options in gastric cancers,indicating a more multidisciplinary management of the disease. Multimodal strategies combining dif-ferent neoadjuvant and/or adjuvant protocols have clearly improved the gastric cancer prognosis when combined with surgery with curative intention. In particular,the perioperative (neoadjuvant,adjuvant) chemotherapy is now a well-established new standard of care for advanced tumors. Adjuvant therapy alone should be carefully discussed after surgical resection,mainly in individual patients with large lymph node positive tumors when neoadjuvant therapy could not be done. The palliative treatment options have also been remarkably improved with new chemotherapeutic agents and will further be enhanced with targeted therapies such as different monoclonal antibodies. This article reviews the most relevant literature on the multidisciplinary management of gastric and gastro-esophageal cancer,and discusses future strategies toimprove locoregional failures. 关 键 词:胃癌 化疗 辅助剂 胃食管癌
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