Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Lordick, Florian; Carneiro, Fátima; Cascinu, Stefano; Fleitas, Tania; Haustermans, Karin; Piessen, Guillaume; Vogel, Arndt; Smyth, Elizabeth

doi:10.1016/j.annonc.2022.07.004

Cited by 649 publications

(563 citation statements)

References 110 publications

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“…23 Molecular pathology assessment in oesophageal and OGJ AC should follow the recommendations provided in the ESMO Clinical Practice Guideline (CPG) for gastric cancer. 26 in these cases, endoscopic resection offers more precise staging in addition to therapeutic benefit. 27,28 EUS is particularly useful to determine the therapeutic strategy in two ways: (i) for assessment of T4b status with invasion towards the airways, pericardium or aorta, and (ii) for identification and biopsy of suspected lymph node metastases outside the regular radiation field or beyond the planned resection limits.…”

Section: Molecular Pathologymentioning

confidence: 99%

“…16,79 Treatment of advanced AC of the oesophagus and OGJ should be in line with the ESMO CPG for gastric cancer. 26 A proposed algorithm for the treatment of advanced oesophageal SCC is shown in Figure 2.…”

Section: Management Of Advanced and Metastatic Diseasementioning

confidence: 99%

“…Supportive care for patients with advanced oesophageal cancer should follow the recommendations provided in the ESMO CPG for gastric cancer, 26 including early palliative care referral and nutritional support.…”

Section: Supportive Care and Nutritionmentioning

confidence: 99%

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Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Alsina²,

et al. 2022

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Section: Molecular Pathologymentioning

confidence: 99%

Section: Management Of Advanced and Metastatic Diseasementioning

confidence: 99%

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Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Alsina²,

et al. 2022

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“…Accurate diagnosis of LNM is one of the foundations of individualized treatment of GC, and it is also of great significance for formulating surgical strategies and assessing the prognosis of GC patients. European Society of Medical Oncology (ESMO) and National Comprehensive Cancer Network (NCCN) guidelines recommend the use of medical imaging for preoperative N staging (5,13). In particular, multidetector computed tomography (MDCT) imaging has been routinely used for preoperative N staging, lymphadenopathy and roundness were signs of LNM.…”

Section: Discussionmentioning

confidence: 99%

Model based on preoperative clinical characteristics to predict lymph node metastasis in patients with gastric cancer

2022

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BackgroundThe risk factors of lymph node metastasis (LNM) in gastric cancer (GC) remain controversial. We aimed to identify risk factors of LNM in GC and construct a predictive model.MethodsA total of 1,337 resectable GC patients who underwent radical D2 lymphadenectomy at the first affiliated Hospital of Anhui Medical University from January 2011 to January 2014 were retrospectively analyzed and randomly divided into training and validation cohorts (n = 1,003 and n = 334, respectively) in a 3:1 ratio. Collecting indicators include age, gender, body mass index (BMI), tumor location, pathology, histological grade, tumor size, preoperative neutrophils to lymphocytes ratio (NLR), platelets to lymphocytes ratio (PLR), fibrinogen to albumin ratio (FAR), carcinoembryonic antigen (CEA), cancer antigen19-9 (CA19-9) and lymph nodes status. Significant risk factors were identified through univariate and multivariate logistic regression analysis, which were then included and presented as a nomogram. The performance of the model was assessed with receiver operating characteristic curves (ROC curves), calibration plots, and Decision curve analysis (DCA), and the risk groups were divided into low-and high-risk groups according to the cutoff value which was determined by the ROC curve.ResultsBMI, histological grade, tumor size, CEA, and CA19-9 were enrolled in the model as independent risk factors of LNM. The model showed good resolution, with a C-index of 0.716 and 0.727 in the training and validation cohort, respectively, and good calibration. The cutoff value for predicted probability is 0.594, the proportion of patients with LNM in the high-risk group was significantly higher than that in the low-risk group. Decision curve analysis also indicated that the model had a good positive net gain.ConclusionsThe nomogram-based prediction model developed in this study is stable with good resolution, reliability, and net gain. It can be used by clinicians to assess preoperative lymph node metastasis and risk stratification to develop individualized treatment plans.

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“…Regulatory approvals of each region regarding first-line chemotherapy plus nivolumab and the recommendations of each guideline are summarized in Table 2 . 2 , 28 , 29 In Europe, the European Medicines Agency (EMA) has approved chemotherapy plus nivolumab as a first-line treatment in patients with a CPS ≥5. Conversely, the United States Food and Drug Administration (FDA) and Japan Ministry of Health, Labor, and Welfare approved the same regardless of CPS status.…”

Section: Regulatory Approval and Guidelinementioning

confidence: 99%

Role of Nivolumab in the Management of First-Line Unresectable Advanced or Recurrent Gastric Cancer in Combination with Chemotherapy: Lessons from the Japanese Experience

Kubota¹,

Aoki²,

Kawazoe³

et al. 2022

CMAR

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Recently, immune checkpoint inhibitor (ICI), such as anti-programmed cell death-1 (PD-1) or programmed cell death ligand-1 (PD-L1) monoclonal antibodies, has provided clinical benefits in various cancer types including advanced gastric cancer (AGC). Nivolumab, a monoclonal anti-PD-1 antibody, firstly showed an improvement in the overall survival (OS) in patients with AGC in the ATTRACTION-2 trial. Recently, chemotherapy plus nivolumab, as a first-line treatment for AGC, showed both OS and progression-free survival (PFS) benefits in patients with PD-L1 combined positive score (CPS) ≥5 in the global CheckMate-649 trial, and demonstrated PFS benefit irrespective of CPS status in the Asian ATTRACTION-4 trial. Based on these results, chemotherapy plus nivolumab in a first-line treatment was approved worldwide. However, the approval requirements and recommendations are different according to the approval agent or country. Thus, this review summarized the clinical trials of chemotherapy plus anti-PD1 antibody as a first-line treatment and focused on the role of nivolumab combined with chemotherapy mainly from the viewpoint of the Japanese experience.

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Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Cited by 649 publications

References 110 publications

Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Model based on preoperative clinical characteristics to predict lymph node metastasis in patients with gastric cancer

Role of Nivolumab in the Management of First-Line Unresectable Advanced or Recurrent Gastric Cancer in Combination with Chemotherapy: Lessons from the Japanese Experience

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