Perioperative chemotherapy versus adjuvant chemotherapy strategies in resectable gastric and gastroesophageal cancer: A Markov decision analysis

Choi, Minsig; Ishizawa, Sayaka; Kraemer, David N.; Sasson, Aaron R.; Feinberg, Eugene A.

doi:10.1016/j.ejso.2021.08.012

Cited by 6 publications

(3 citation statements)

References 42 publications

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“…Studies show mixed results for outcomes based on sequence of therapy. Meta‐analyses and a decision analysis have suggested a survival benefit with perioperative chemotherapy as opposed to adjuvant strategies 34–36 . However, randomized trials of perioperative versus adjuvant chemotherapy for GC, which have taken place in Asia and limited to study populations with advanced disease, have largely failed to show an OS benefit for preoperative chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Meta‐analyses and a decision analysis have suggested a survival benefit with perioperative chemotherapy as opposed to adjuvant strategies. 34 , 35 , 36 However, randomized trials of perioperative versus adjuvant chemotherapy for GC, which have taken place in Asia and limited to study populations with advanced disease, have largely failed to show an OS benefit for preoperative chemotherapy. In a randomized clinical trial conducted in Japan, Iwasaki et al failed to demonstrate a benefit in survival with the addition of neoadjuvant S‐1 plus cisplatin to the usual regimen of gastrectomy with a D2 lymphadenectomy and adjuvant chemotherapy (S‐1) in advanced GC (macroscopic types 3 and 4).…”

Section: Discussionmentioning

confidence: 99%

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The order of surgery and chemotherapy matters: Multimodality therapy and stage‐specific differences in survival in gastric cancer

Ramos-Santillan

Friedmann

Eskander

et al. 2022

Journal of Surgical Oncology

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Background and Objectives: Multimodality treatment improves survival for gastric cancer (GC). However, the effect of treatment sequence by stage remains unclear.We aim to compare outcomes between patients receiving neoadjuvant(neoadj) and adjuvant chemotherapy (adj). Methods: Nonmetastatic GC patients with clinical stage ≥ T2N0 who underwent both resection and neoadj or adj were identified using the National Cancer Database (2005−2014). Multivariable Cox regression analyses were performed on propensity score-matched (PSM) cohorts stratified by stage to compare overall survival (OS). Results: We identified 11 984 patients; 55% stage I (SI), 76% stage II (SII) and 57% stage III (SIII) received neoadj. Unadjusted analysis showed worse survival among SI neoadj patients (hazard ratio [HR] 1.195, confidence interval [CI] 1.04−1.38) and improved survival for SII (HR 0.93 CI 0.87−0.998) and SIII (HR 0.75, CI 0.68−0.84).After PSM, SI patients with neoadj had worse OS with increased risk of death compared to Adj (HR 1.186, CI 1.004−1.402). SII patients had no difference in OS (HR 0.98, CI 0.91−1.07) and SIII patients had improved OS (HR 0.78, CI 0.69−0.90). Conclusions:In patients who received surgery and chemotherapy, the benefit of neoadj was limited to SIII with worse survival for SI. A clinical trial to examine the optimal sequence of chemotherapy is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The order of surgery and chemotherapy matters: Multimodality therapy and stage‐specific differences in survival in gastric cancer

Ramos-Santillan

Friedmann

Eskander

et al. 2022

Journal of Surgical Oncology

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“…Te proportion of EC patients who are suitable for immediate surgical intervention upon diagnosis is only 10% [77]. Resectable EC is typically managed through a multimodal approach involving surgical intervention, with or without adjuvant chemotherapy, and chemoradiotherapy [79,80]. Chemotherapy, chemoradiotherapy, immunotherapy, and targeted therapy are potential treatment options for patients declared inoperable [81][82][83].…”

Section: Esophageal Cancermentioning

confidence: 99%

Chitosan and Its Derivative-Based Nanoparticles in Gastrointestinal Cancers: Molecular Mechanisms of Action and Promising Anticancer Strategies

Shokati Eshkiki,

Mansouri,

Karamzadeh

et al. 2024

Journal of Clinical Pharmacy and Therapeutics

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Gastrointestinal cancers account for a significant health concern as the existing treatment modalities, such as surgery, chemotherapy, and radiation therapy, exhibit considerable drawbacks, including a high probability of recurrence, insufficient drug specificity, and severe adverse effects. Hence, novel therapeutic approaches and enhanced tissue-specific targeting are required. Nanomedicine is a field of medicine that uses nanoscale carriers for targeting and administering drugs or diagnostic agents to particular tissues. In the field of nanomedicine, chitosan nanoparticles are well-established delivery technologies used as polymeric carriers. Chitosan is a natural carbohydrate that is biocompatible, biodegradable, polycationic, and mucoadhesive. Chitosan has shown promise in the administration of chemotherapeutic drugs, gene therapy, and immunotherapy for the treatment of gastrointestinal cancers. The limited water solubility of chitosan is one of its major disadvantages as a drug delivery system. Thus, solubility may be increased by chemically treating chitosan. Chitosan derivatives improve the activity, selectivity, biocompatibility, and therapeutic dose reduction of anticancer drugs when used in hydrogel, emulsion, surfactant formulations, and nanoformulation. Chitosan and its derivatives have shown effectiveness in nanoparticle production and exhibit unique surface properties, enabling them to interact selectively with gastrointestinal tumors through both active and passive targeting mechanisms. This review focuses on the molecular signaling pathways of chitosan nanoparticles and their derivatives as potential anticancer agents. The potential of future chitosan applications in gastrointestinal cancers is additionally highlighted.

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Comparative outcomes of laparoscopic and robotic approaches to gastrectomy: a National Cancer Database study

et al. 2023

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Perioperative chemotherapy versus adjuvant chemotherapy strategies in resectable gastric and gastroesophageal cancer: A Markov decision analysis

Cited by 6 publications

References 42 publications

The order of surgery and chemotherapy matters: Multimodality therapy and stage‐specific differences in survival in gastric cancer

The order of surgery and chemotherapy matters: Multimodality therapy and stage‐specific differences in survival in gastric cancer

Chitosan and Its Derivative-Based Nanoparticles in Gastrointestinal Cancers: Molecular Mechanisms of Action and Promising Anticancer Strategies

Comparative outcomes of laparoscopic and robotic approaches to gastrectomy: a National Cancer Database study

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