Gastric cancer: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO)

Zaanan, Aziz; Bouché, Olivier; Benhaïm, Léonor; Bruno, Benedetto; Chapelle, Nicolas; Dubreuil, Olivier; Farés, Nadim; Granger, Victoire; Lefort, Christine; Gagnière, Johan; Meilleroux, Julie; Baumann, Anne-Sophie; Vendrely, V.; Ducreux, Michel; Michel, Pierre

doi:10.1016/j.dld.2018.04.025

Cited by 79 publications

(61 citation statements)

References 87 publications

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“…Although improvements in adequate lymph node dissection, the majority of advanced gastric cancer patients treated with surgery alone cannot successfully undergo R0 resection and relapse with high recurrence and mortality rates. Now, there is a standard consensus worldwide regarding combination neoadjuvant chemotherapy followed by surgery in resectable GC patients, as a means of resulting in tumor downstaging, improving resectability, and eradicating micrometastases, particularly in patients diagnosed at an advanced stage [17].…”

Section: Discussionmentioning

confidence: 99%

FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

Zhang

Yan

Sun

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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Background. The prognosis of patients with advanced gastric cancer remains unsatisfactory, highlighting the need for improved therapeutic strategies. We analyzed 23 resectable advanced gastric cancer patients who received FLOT followed by laparoscopic gastrectomy with D2 lymphadenectomy to evaluate the efficacy and safety. Methods. Patients aged 18–75 years with gastric adenocarcinoma (stage cT3–4 and/or N + M0) underwent neoadjuvant FLOT therapy (four preoperative and four postoperative 2-week cycles) at Shanghai East Hospital. Laparoscopic gastrectomy was scheduled 3-4 weeks after completion of the last cycle of preoperative chemotherapy. The type of surgical procedure was determined by the location and extent of the primary tumor. Results. 23 patients were reviewed in the study. 20 patients (81.2%) received four courses of FOLT therapy, while 3 patients (18.8%) received three courses of treatment. There were 3 (13.0%) complete responses, 13 (56.5%) partial responses, 4 (26.1%) of stable disease, and 1 (4.3%) of progressive disease. The clinical efficacy response rate was 69.6%. The R0 resection rate was 91.3%. Only one patient exhibited grade III postoperative complications. The pathologic complete remission was 13%. The common grade 3/4 adverse events from chemotherapy were leucopenia (17.4%), neutropenia (30.4%), anemia (13%), anorexia (13%), and nausea (17.4%). Postoperative complications occurred in 5 patients (26.1%). There was no treatment-related mortality or reoperation. The most reason for not completing chemotherapy was the patient’s request. Conclusions. These findings suggest that FLOT neoadjuvant chemotherapy, followed by laparoscopic D2 gastrectomy, is effective and safe in advanced, resectable advanced gastric cancer.

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Section: Discussionmentioning

confidence: 99%

FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

Zhang

Yan

Sun

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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“…Staging laparoscopy (SL) has been incorporated into the diagnostic strategy for advanced gastric cancer (GC) for years. In some therapeutic guidelines, SL is recommended for preoperative staging. Historically, the value of SL has been controversial.…”

Section: Introductionmentioning

confidence: 99%

Role of staging laparoscopy for gastric cancer patients

Fukagawa

2019

Annals of Gastroent Surgery

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Staging laparoscopy (SL) is frequently carried out in patients with advanced gastric cancer. However, some clinical questions are being debated and consensus must be obtained. With this aim, a literature search of PubMed/MEDLINE was carried out using the keywords “gastric cancer,” “SL,” and “diagnostic laparoscopy”. Articles published online up to February 2019 were analyzed, focusing on the following questions. (i) What is an adequate indication for SL? (ii) How do you carry out SL? (iii) Does SL provide accurate information about peritoneal dissemination? (iv) Is the yield of SL different by tumor location? (v) Is SL a safe procedure? (vi) Is “repeat SL” needed? (vii) Does SL provide oncological benefit? Results provided the following responses: (i) In Western countries, clinically resectable advanced tumor is an indication for SL. Terms to be introduced for adequate indication include “location,” “type 4 (linitis feature),” “large tumor,” “equivocal computed tomography (CT] findings,” and “lymph node swelling”. (ii) Exploration of the entire peritoneal cavity is preferable. (iii) Detection rate of peritoneal disease is 43%‐52% in Japanese institutions and 7.8%‐40% in other countries. False‐negative findings during SL were 0%‐17%, and 10%‐13% when limited to cytology. (iv) Yield of SL was higher in gastric cancer compared with esophagogastric junctional tumor. (v) SL‐related complications were estimated to occur in 0.4%. (vi) Repeat SL is important after treatment. (vii) If the efficacy of neoadjuvant chemotherapy for patients with P0CY1 is established, SL can provide oncological benefit. SL can be carried out safely and effectively. Considering the prevalence of neoadjuvant treatment, the role of SL will become more important.

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“…Several international societies have published their respective consensus and guidelines 2,3,4,8,12,13,19,20,22 . In fact, it is paramount that each country has its own consensus.…”

Section: Discussionmentioning

confidence: 99%

Ii Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association

Barchi

Ramos

Dias

et al. 2020

ABCD, arq. bras. cir. dig.

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Background: Since the publication of the first Brazilian Consensus on Gastric Cancer (GC) in 2012 carried out by the Brazilian Gastric Cancer Association, new concepts on diagnosis, staging, treatment and follow-up have been incorporated. Aim: This new consensus is to promote an update to professionals working in the fight against GC and to provide guidelines for the management of patients with this condition. Methods: Fifty-nine experts answered 67 statements regarding the diagnosis, staging, treatment and prognosis of GC with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. This article presents only the responses of the participating experts. Comments on each statement, as well as a literature review, will be presented in future publications. Results: Of the 67 statements, there was consensus in 50 (74%). In 10 declarations, there was 100% agreement. Conclusion: The gastric cancer treatment has evolved considerably in recent years. This consensus gathers consolidated principles in the last decades, new knowledge acquired recently, as well as promising perspectives on the management of this disease.

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Gastric cancer: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO)

Abstract: These guidelines in gastric cancer are done to help decision for daily clinical practice. These recommendations are permanently being reviewed. Each individual case must be discussed within a multidisciplinary team.

Cited by 79 publications

References 87 publications

FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer

Role of staging laparoscopy for gastric cancer patients

Ii Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association

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