Adjuvant chemotherapy for gastric cancer: a comprehensive review

Maehara, Yoshihiko; Baba, Hideo; Sugimachi, Keizō

doi:10.1007/s10120-001-8008-6

Cited by 14 publications

(10 citation statements)

References 66 publications

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“…17,18 In invasive bladder cancers, two randomized trials revealed a benefit of adjuvant chemotherapy compared with radical cystectomy alone. 19,20 These two reports showed the apparent benefit of the chemotherapy in patients who had especially poor-risk cancers (pT3 or pNϩ), although each of these trials included fewer than 100 patients, and both were terminated prematurely, on the basis of an interim analysis favoring the chemotherapy group, without evaluating overall survival curves as an endpoint.…”

Section: Discussionmentioning

confidence: 99%

The current status of perioperative chemotherapy for invasive bladder cancer: a multiinstitutional retrospective study in Japan

et al. 2004

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Tumor-infiltrating lymphocytes (TIL) play a central role in cellular immunity against tumor. We have revealed the characteristics of TILs in terms of T-cell receptor (TCR) repertoire, T-cell clonality, and cytokine production. TCR repertoire analyses and CDR3 size spectratyping were performed using peripheral blood mononuclear cells (PBMCs) and tissue specimens of gastric or colorectal cancers surgically resected from 11 patients. The cytokine expression was measured by real-time quantitative polymerase chain reaction. TCR repertoires were similar among multiple tissue specimens from different sites of the same tumor. Similar peak patterns of CDR3 size spectratyping were observed among these tumor specimens, but not in normal tissues or PBMCs. In addition, identical peaks were detected in multiple specimens of the same tumor. The ratio of the levels of IFN-gamma to that of IL-4 is significantly higher for tumor lesions compared with PBMCs. These results suggested that a limited number of TILs locally expand in response to tumor antigens exiting within gastric or colorectal cancers and local predominant production of the T helper 1/T cytotoxic 1 type cytokine may affect the anti-tumor immune response of TILs.

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Section: Discussionmentioning

confidence: 99%

The current status of perioperative chemotherapy for invasive bladder cancer: a multiinstitutional retrospective study in Japan

et al. 2004

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“…It is unclear whether a better prognosis exists if neoadjuvant chemotherapy removes the peritoneal dissemination macroscopically before curative surgical resection is performed. Also, it is unclear whether neoadjuvant chemotherapy is superior to adjuvant chemotherapy after surgery [8,15]. In our patient, the tumor had massive peritoneal dissemination, and its histological type was mainly mucinous gastric carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant chemotherapy with S-1 and surgical resection for a mucinous gastric cancer with peritoneal dissemination

et al. 2005

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cisplatin (CDDP). Excellent clinical and experimental results have been reported with S-1 for peritoneal dissemination [4], but long-term survival without recurrence is rare, as only a few cases of long-term survival have been reported. Curative surgery is the recommended treatment for gastric cancer. The results of surgery without curability for stage IV patients are generally dismal. It is not known whether or not adjuvant chemotherapy with new anticancer agents such as S-1 is beneficial for the survival of patients with peritoneal dissemination. As curative surgery is considered to be the best therapy for gastric cancer, downstaging with adjuvant chemotherapy and curative surgery is a possibility to improve the prognosis of stage IV gastric cancer patients, after precise preoperative staging.We report the case of a patient with a gastric carcinoma in which peritoneal dissemination disappeared after neoadjuvant chemotherapy with S-1 alone. The patient has survived for over 23 months since the operation, without evidence of recurrence. Case reportA 60-year-old man with anorexia was referred to our hospital, with advanced gastric cancer, detected at an other hospital by upper gastrointestinal endoscopy. Preoperative abdominal computed tomography (CT) scan showed a small amount of ascites and an infiltrative soft-tissue lesion in the peritoneal fat or on the peritoneal surface, suggesting peritoneal dissemination (Fig. 1A). CT also showed lymphadenopathy, which was indicative of metastases, on the lesser curvature of the stomach. Physical examination revealed no specific problems. The serum carcinoembryonic antigen (CEA) level was 1.2 ng/ml and the carbohydrate antigen (CA) 19-9 level was 5.7 U/ml.Gastrointestinal endoscopy revealed that the tumor was located on the greater curvature of the stomach,

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“…4 On the other hand, in Japan, adjuvant chemotherapy using oral chemotherapy has been investigated for decades as postoperative adjuvant chemotherapy, without suffi ciently robust evidence for its effi cacy. 5 This difference between United States and Japanese perspectives regarding adjuvant chemotherapy for gastric cancer may result from a difference in backgrounds. In the United States, the standard "curative operation" refers to gastrectomy plus D0 or D1 lymphadenectomy, and chemoradiotherapy appears to be effective for local control after curative resection.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of adjuvant chemotherapy using tegafur-based regimen for curatively resected gastric cancer: update of a meta-analysis

Oba¹

2009

Int J Clin Oncol

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A consensus regarding standard adjuvant chemotherapy for curatively resected gastric cancer has not been obtained between Japan and the Western world. In order to evaluate the effect of a tegafur-based regimen (the most frequently used regimen in Japan) compared with a surgery-alone control, a meta-analysis was performed, investigating four clinical trials. After meticulous examination of each trial, trials with improper noncentralized randomization were excluded from the analysis. A total of 1197 patients were enrolled in the four relevant trials determined to be eligible for the meta-analysis (Nakajima 1984; Japan Clinical Oncology Group [JCOG] 8801, JCOG 9206-2, and National Surgical Adjuvant Study of Gastric Cancer [NSASGC], in which a tegafur-based regimen was used for chemotherapy and central randomization was performed. The endpoint was overall survival, and a common hazard ratio was estimated. The 5-year overall survival rates differed among the trials because of differences in the background disease status. But there was no heterogeneity (P = 0.235) of treatment effect. The estimated common hazard ratio was 0.75, with a 95% confidence interval of 0.58-0.98. The treatment effect of the tegafur-based agent was shown to be statistically significant (P = 0.037) compared with surgery-alone therapy (n = 1179). From the results of the above meta-analysis, it is suggested that chemotherapy with a tegafur-based agent after surgery can improve the survival of patients with curatively resected gastric cancer. The Global Advanced/Adjuvant Stomach Tumor Research through International Collaboration (GASTRIC) group is conducting two individual patient data meta-analyses, testing post-operative adjuvant chemotherapy for resect-able gastric cancer and chemotherapy for advanced gastric cancer. It is expected to determine and quantify the role of adjuvant chemotherapy in detail from the GASTRIC.

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Adjuvant chemotherapy for gastric cancer: a comprehensive review

Cited by 14 publications

References 66 publications

The current status of perioperative chemotherapy for invasive bladder cancer: a multiinstitutional retrospective study in Japan

The current status of perioperative chemotherapy for invasive bladder cancer: a multiinstitutional retrospective study in Japan

Neoadjuvant chemotherapy with S-1 and surgical resection for a mucinous gastric cancer with peritoneal dissemination

Efficacy of adjuvant chemotherapy using tegafur-based regimen for curatively resected gastric cancer: update of a meta-analysis

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