Article

Present and future status of gastric cancer surgery.

Gastric Surgery Division, National Cancer Center Hospital, Chuo-ku, Tokyo 104-0045, Japan.
Japanese Journal of Clinical Oncology (impact factor: 1.78). 01/2011; 41(3):307-13. DOI:10.1093/jjco/hyq240 pp.307-13
Source: PubMed

ABSTRACT The type of surgery and the role of adjuvant therapies in the treatment of gastric cancer have changed in recent times. The treatment of gastric cancer with curative intent is moving away from standard D2 or more extensive surgery to a tailored approach depending on the stage of the disease. Data collected from extensive lymphadenectomy for all stages of gastric cancer have confirmed that some subsets of early gastric cancer are very low risk for nodal metastasis. This group of patients may benefit from resection by endoscopic or laparoscopic techniques and may also be suitable for function-preserving procedures. The extent of resection for gastric cancer has always excited debate. D2 gastrectomy was criticized for its higher mortality in the early European Phase III trials, but recent studies from Taiwan and Italy have shown that the procedure is safe when performed by experienced surgeons and has a survival benefit over D1 gastrectomy. The role of para-aortic lymph node dissection for nodes without apparent metastasis in advanced gastric cancer was assessed by a Phase III Japanese trial and showed no additional benefit over D2 resection. Radical gastric resections, involving resection of adjacent organs for direct tumor invasion result in higher rates of complications, and the role of multi-visceral resections has also been reevaluated. Effective adjuvant therapies for gastric cancer have been reported since the early part of 2000. Development of more effective adjuvant therapy combined with D2 resection should continue to improve survival in the future.

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    Article: T cells and adoptive immunotherapy: recent developments and future prospects in gastrointestinal oncology.
    Amedeo Amedei, Elena Niccolai, Mario M D'Elios
    [show abstract] [hide abstract]
    ABSTRACT: Gastrointestinal oncology is one of the foremost causes of death: the gastric cancer accounts for 10.4% of cancer deaths worldwide, the pancreatic cancer for 6%, and finally, the colorectal cancer for 9% of all cancer-related deaths. For all these gastrointestinal cancers, surgical tumor resection remains the primary curative treatment, but the overall 5-year survival rate remains poor, ranging between 20-25%; the addition of combined modality strategies (pre- or postoperative chemoradiotherapy or perioperative chemotherapy) results in 5-year survival rates of only 30-35%. Therefore, many investigators believe that the potential for making significant progress lies on understanding and exploiting the molecular biology of gastrointestinal tumors to investigate new therapeutic strategies such as specific immunotherapy. In this paper we will focus on recent knowledge concerning the role of T cells and the use of T adoptive immunotherapy in the treatment of gastrointestinal cancers.
    Clinical and Developmental Immunology 01/2011; 2011:320571. · 1.84 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

additional benefit
 
adjacent organs
 
adjuvant therapies
 
apparent metastasis
 
D1 gastrectomy
 
D2 gastrectomy
 
D2 resection
 
direct tumor invasion result
 
Effective adjuvant therapies
 
effective adjuvant therapy
 
European Phase III trials
 
extensive surgery
 
higher rates
 
laparoscopic techniques
 
multi-visceral resections
 
nodal metastasis
 
Radical gastric resections
 
recent times
 
standard D2
 
survival benefit
 

Makoto Saka