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Optimal management of resected gastric cancer

Authors Giampieri R, Del Prete M, Cantini L, Baleani MG, Bittoni A, Maccaroni E, Berardi R

Received 16 September 2017

Accepted for publication 11 December 2017

Published 21 June 2018 Volume 2018:10 Pages 1605—1618


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Kenan Onel

Riccardo Giampieri, Michela Del Prete, Luca Cantini, Maria Giuditta Baleani, Alessandro Bittoni, Elena Maccaroni, Rossana Berardi

Oncology Clinic, AOU Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy

Abstract: Although advances in medical treatment for gastric cancer (GC) have been made, surgery remains the mainstay of cure for patients with localized disease. Improvement in surgical modalities leads to increased chance of cure for resected patients, but a non-negligible number of patients eventually relapse. On this basis, it has been hypothesized that the addition of complementary systemic or local treatments (such as chemotherapy and radiotherapy) could help in improving patients’ survival by reducing the risk of recurrence. Several studies have tried to identify the best approach in localized GC: some of them have assessed the role of perioperative chemotherapy [CT] with different drug combinations, while others have focused on the benefit obtained by addition of radiotherapy, whose role is still under investigation. In particular, the role of chemoradiotherapy, both in adjuvant and neoadjuvant settings, is still uncertain. In the last few years, several clinicopathological and molecular factors have been investigated and identified as potential prognostic markers in GC. Many of these factors could have influenced the outcome of patients receiving combined treatments in the abovementioned studies. Patients have not been generally distinguished by the site of disease (esophageal, gastric and junctional cancers) and surgical approach, making data difficult to be interpreted. The purpose of this review was to shed light on these highly controversial topics.

Keywords: gastric cancer, chemotherapy, radiotherapy, adjuvant, neoadjuvant, prognostic factors

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