Japanese gastric cancer treatment guidelines 2014 (ver. 4)

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doi:10.1007/s10120-016-0622-4

Cited by 2,052 publications

(740 citation statements)

References 55 publications

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“…Standard gastrectomy continues to play a major role in the treatment of resectable gastric cancer, and comprises resection of the distal part of more than two thirds of the whole stomach along with concomitant lymphadenectomy [2]. Postoperative malnutrition due to, among other things, the loss of reservoir function in the upper gastrointestinal tract is deemed inevitable [3], and patients who underwent open distal gastrectomy demonstrated body weight loss (BWL) of 13% in the 6 months postoperatively, whereas those who underwent total gastrectomy lost 17% of body weight [4].…”

Section: Introductionmentioning

confidence: 99%

Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301)

et al. 2016

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Background Postoperative malnutrition after gastrectomy is deemed inevitable, which could have prejudicial influence on survival for gastric cancer patients. A prospective feasibility study was conducted to evaluate the efficacy of postoperative oral nutritional supplements. Methods Stage I-III gastric cancer patients who underwent distal or total gastrectomy received oral administration of Racol Ò NF (Otsuka Pharmaceutical Factory, Japan), a liquid enteral nutritional formula, as a supplement to regular meals. Racol Ò NF administration at a recommended dosage of 400 kcal/400 ml per day was started within 7 days postoperatively and was continued for 3 months postoperatively. The primary end point was ratio of the weight loss at 3 months postoperatively to the preoperative body weight (body weight loss ratio). Secondary end points were the adherence to Racol Ò NF therapy and changes in body composition. Results One hundred eighteen patients were registered before surgery, 82 of whom were eligible for efficacy analyses. The average rate of body weight loss after 3 months postoperatively was 8.3%. The mean daily intake of Racol Ò NF was 211 ml. There was a significant correlation between adherence to Racol Ò NF therapy and body weight loss ratio (P \ 0.001). Adherence to Racol Ò NF therapy was the only factor that correlated with the body weight loss ratio among all clinical characteristics by the multiple linear regression analysis (P = 0.007). Conclusions Oral nutritional supplementation with Racol Ò NF led to a significant reduction in body weight loss for gastrectomized patients who tolerated more than 200 ml of the nutrient per day compared with those who could not tolerate this amount.

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Section: Introductionmentioning

confidence: 99%

Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301)

et al. 2016

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“…Surgical resection is the mainstay of treatment for gastric carcinoma that can achieve complete removal of tumors and lymph nodes. ESD has been considered a feasible alternative to surgical resection for tumors with mucosal or minute submucosal invasion, because for these tumors there is little or no risk of lymph node metastasis [17,20]. Several recent studies have compared the clinical and oncological outcomes of ESD with gastrectomy, demonstrating favorable outcomes of ESD in terms of survival as well as perioperative outcomes [10,[21][22][23].…”

Section: Data Represent the Number Of Patients (%) Or The Median (Intmentioning

confidence: 99%

“…Patients were classified according to absolute and expanded criteria based on the final pathological diagnosis [17]. The absolute indication for endoscopic resection was mucosal, differentiated tumor without ulceration, B2 cm.…”

Section: Definitionsmentioning

confidence: 99%

Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for esophagogastric junction adenocarcinoma

et al. 2016

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Background Endoscopic submucosal dissection (ESD) has become accepted as the standard treatment for early gastric cancer. However, comparative outcomes of ESD and surgery have not been evaluated for adenocarcinoma in the esophagogastric junction (EGJ). We investigated the longterm outcomes of ESD compared with those of surgery for adenocarcinoma in the EGJ. Methods Patients who underwent ESD or surgery for Siewert type II adenocarcinoma between 2005 and 2010 and who met the absolute and expanded criteria for endoscopic resection were eligible. Clinical features and treatment outcomes were retrospectively reviewed using medical records. Results Of the 79 patients included, 40 underwent ESD and 39 underwent surgery. During the median follow-up period of 60.9 months (range, 13.1-125.4 months), the 5-year overall survival rates were 93.9% and 97.3% for the ESD and surgery groups, respectively (p = 0.376). There were no gastric cancer-related deaths in either group. Adverse events occurred in 11 patients (13.9%) overall, and the incidence of treatment-related adverse events was similar between the two groups (10.0% vs. 17.9%, p = 0.308).Conclusions ESD may be an effective alternative to surgery for the treatment of early gastric cancer in the EGJ based on the comparable long-term outcomes.

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“…16 However, because Japanese and Korean physicians have been building a therapeutic algorithm for the treatment for GC 17 over time according to their abundant experience and evidence based on their high quality of pathologic [13][14][15] and endoscopic 18 diagnosis combined with that of endoscopic and surgical treatment, including ER and D2 dissection, 9,16,19 it may be good for Western physicians to create their own therapeutic algorithm based on the Eastern high quality of diagnostic and therapeutic methods, taking into account the characteristics of the region, including race. 10 In conclusion, active discussion, communication, and collaboration between Western and Eastern endoscopists, pathologists, surgeons, and medical oncologists, particularly in terms of diagnostic and therapeutic methods, must be the key to bridging the West and the East in the treatment for GC.…”

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How Do We Bridge the West and the East in the Treatment for Gastric Cancer?

Suda

Kitagawa

2016

Ann Surg Oncol

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In 2012, gastric cancer (GC) was the fifth most common malignancy and the third leading cause of cancer death in the world. 1 The prevalence of GC remains more common in countries of the Far East, including Japan and Korea, than in countries of the West.2 Moreover, better overall survival (OS) has been reported in Eastern trials than the Western series (East vs West 5-year OS: 60-70 vs 30-40 %) [3][4][5][6][7] Eastern investigators may argue that this difference is attributable to more radical surgery, whereas Western investigators may claim that this difference is attributable to earlier detection and differences in biology. 8,9 Recently, Ikoma et al. 10,11 at MD Anderson Cancer Center, in which the standard extent of lymph node dissection has been D2, reported the factors contributing to lymph node metastasis and the 5-year OS of patients with pathologic stage T1 or T2 GC. In their single-institution retrospective study, 122 patients with T1 or T2 GC who underwent R0 resection without preoperative treatment were examined.10,11 Extended lymph node dissection (D1 ?/D2) was performed for 55 % of the patients.11 As a result, race, T1b stage or higher, and 15 or more lymph nodes examined were risk factors for lymph node metastasis, 10 whereas T2 stage, but not race or nodal status, was the only variable independently associated with 5-year OS.11 The lymph node metastasis rates were 10 % for stage T1a, 34 % for stage T1b, and 44 % for stage T2 tumor. 10The 5-year OS was 98 % for stage T1a, 93 % for stage T1b, and 66 % for stage T2 tumors.11 Collectively, surgical resection with locoregional lymph node dissection mostly cured early GC, although the rates for lymph node metastasis were higher for each T stage than those found in reports from Asia.10,11 Although their study had a couple of limitations, including its retrospective design and relatively small sample due to their preference for preoperative therapy used for T2 stage or higher, N ? tumor, or both, 10,11 these outcomes suggest that indications for endoscopic resection (ER) should be more confined, at least in their region than in Japan, in which ER has been extensively indicated for early GC.In reality, many clear differences that may account for better long-term outcomes in the East than in the West exist, namely, earlier detection of GC because of mass cancer screening programs based on higher incidence, 12 pathologic evaluation focused more on nuclear cytologic and glandular architecture abnormalities, 13-15 tumor biology including more distal location as well as more differentiated histology, 9 wider adoption of ER for early GC and D2 lymphadenectomy for advanced GC,8,9 and less frequent use of preoperative chemotherapy.16 However, because Japanese and Korean physicians have been building a therapeutic algorithm for the treatment for GC 17 over time according to their abundant experience and evidence based on their high quality of pathologic [13][14][15] and endoscopic 18 diagnosis combined with that of endoscopic and surgical treatment, including ER an...

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Japanese gastric cancer treatment guidelines 2014 (ver. 4)

Cited by 2,052 publications

References 55 publications

Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301)

Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301)

Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for esophagogastric junction adenocarcinoma

How Do We Bridge the West and the East in the Treatment for Gastric Cancer?

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