Guidelines for the management of oesophageal and gastric cancer

Allum, William; Blazeby, Jane; Griffin, S. M.; Cunningham, David; Jankowski, Janusz; Wong, Rachel

doi:10.1136/gut.2010.228254

Cited by 622 publications

(363 citation statements)

References 415 publications

(194 reference statements)

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“…Endoscopy, cross-sectional imaging, and tumor markers have all been evaluated, but lack specificity or sensitivity [53]. …”

Section: International Guidelines Review and Expert Interviewmentioning

confidence: 99%

Follow-Up: The Evidence

D’Ugo¹,

Biondi²,

Tufo³

et al. 2013

Dig Surg

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There is currently no consensus on the best strategy for the follow-up of patients who have undergone surgical treatment with curative intent for gastric cancer. The wide variation in recommendations for surveillance among international experts and hospital schedules clearly reflects a lack of an established body of evidence on this subject. Consequently, most of the international guidelines aimed at early detection of disease recurrence gloss over details concerning the mode, duration, and intensity of surveillance since they cannot be based on an acceptable grade of recommendation. Very few report anything other than the detection of recurrences or death as the primary endpoints, and, given the poor survival of patients with recurrent gastric cancer, the prognostic effect of early detection seems doubtful. In recent years, an increasing focus on evidence-based medicine, which has coincided with a growing concern about costs and efficiency in medicine, has caused a reevaluation of most surveillance practices. In this paper, we review and discuss the current body of evidence and follow-up practices after curative resection of gastric cancer.

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“…Endoscopy, cross-sectional imaging, and tumor markers have all been evaluated, but lack specificity or sensitivity [53]. …”

Section: International Guidelines Review and Expert Interviewmentioning

confidence: 99%

Follow-Up: The Evidence

D’Ugo¹,

Biondi²,

Tufo³

et al. 2013

Dig Surg

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“…The finding shown by Murphy et al, supported by the above cited systematic review, provide more robust data that should invite to reflect the Scientific Community on the opportunity to consider pernicious anemia to be premalignant condition that justify endoscopic monitoring as suggested by the British Society of Gastroenterology (7).…”

Section: Accepted Manuscriptmentioning

confidence: 89%

Pernicious Anemia: Time to Justify Endoscopic Monitoring?

Lahner¹,

Esposito²,

Annibale³

2016

Clinical Gastroenterology and Hepatology

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“…Epirubicin was included in this combination because of anticipated enhanced cytotoxicity (Sumpter et al, 2005;Lee et al, 2008;Allum et al, 2011;Chan et al, 2011). Consequently the combination Epirubicin, cisplatin and 5-FU (ECF) in a randomized Phase III study showed superior response rates and significantly prolonged survival when compared with the historic reference regimen 5-FU, doxorubicin and methotrexate (FAMTX) (Webb et al, 1997;Sumpter et al, 2005;Lee et al, 2008;Allum et al, 2011;Chan et al, 2011). Therefore, the ECF regimen has represented a step ahead in the treatment of advanced gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover several studies reported response rates of over 50% with ECF, with apparently moderate toxicity and satisfactory symptom control (Ross et al, 2002;Hejna et al, 2006). And when it compared with FAMTX, it showed a higher response rate (45% vs 21%) and longer survival duration (8.9 months vs 5.7 months), with less myelosuppression, less mucositis, and better quality of life (Webb et al, 1997, Sumpter et al, 2005Lee et al, 2008;Allum et al, 2011;Chan et al, 2011). However, the protracted infusion of 5-FU is expensive, in addition it needs special infusion pump and a well educated patient, consequently, several studied tried to make it convenient either by using 5FU with high dose leucovorin on day 1and 8 in a cycle repeated every 21 days (Karapetis et al, 2010) or to use it biweekly (Felici et al, 2006) with significant benefits.…”

Section: Introductionmentioning

confidence: 99%

ECF with Infusional Fluorouracil for 5 Days in Locally Advanced and Metastatic Gastric Cancer, Is It Better than the Standard?

Ibrahim¹,

Gabr²,

Hefny³

2013

CCO

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The ECF (Epirubcin/Cisplatin/5-fluorouracil) first therapy in metastatic gastric is the optimal therapeutic option but its complexity limits its utility in many communities. We investigated a more convenient modification of the standard approach, "5 days CIV 5-fluorouracil 1000mg/m 2 ". A total of 115 patients with advanced and metastatic adenocarcinoma of the stomach and gastroesophageal cancer were reviewed retrospectively to compare the efficacy of modified ECF N=41 with the reference protocols FAM N=32 and ELF N=42. The overall response rate was 36.5% with ECF, 16.6% with ELF, and 15.6% with FAM, with significant differences p=0.001. No one achieved a complete tumor regression. However, 4 patients with locally advanced stomach were able to have total gastrectomy in ECF arm only with p=0.000. Hematologic toxicities were more common in ECF p= 0.01. On the other hand, there was no significant difference in progression free survival or overall survival between the three regimens. Modified ECF showed significant overall response than FAM and FLF. However survival benefit is very small. So we recommend using this regimen as neoadjuvant treatment.

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Guidelines for the management of oesophageal and gastric cancer

Cited by 622 publications

References 415 publications

Follow-Up: The Evidence

Follow-Up: The Evidence

Pernicious Anemia: Time to Justify Endoscopic Monitoring?

ECF with Infusional Fluorouracil for 5 Days in Locally Advanced and Metastatic Gastric Cancer, Is It Better than the Standard?

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