Explanation of the 7 Clinical Questions in Japanese Gastric Cancer Treatment Guidelines of Version 4
Journal of Surgery
Volume 6, Issue 5, October 2018, Pages: 112-115
Received: Jul. 15, 2018;
Accepted: Aug. 8, 2018;
Published: Sep. 5, 2018
Views 1221 Downloads 131
Zhi Zhu, Department of Surgical Oncology, the First Hospital of China Medical University, Shenyang, China
Junqing Chen, Department of Surgical Oncology, the First Hospital of China Medical University, Shenyang, China
Surgery is the main treatment for curing gastric cancer, standard D2 gastrectomy and systematical therapy provides an excellent survival outcome in East Asian countries, especially Japan, Korea, and China, however, there are many clinical questions still under debate for a long time. Japanese gastric cancer treatment guidelines has produced a great effect on the surgical treatment of gastric cancer. The treatment of gastric cancer is more standardized, rationalized and normalized. In recent years, new research results made the guideline revised. The 4th Edition of 2014 has proposed a solution for Stage IV patients with single non-curative factors. Patients with No.16a2, b1 lymphnodes metastasis, liver metastasis, or with peritoneal metastasis/CY1 disease are scheduled to receive combined treatment of operation and chemotherapy. The 4th edition incorporated new evidence that includes those delivered as a quick bulletin in the website of the Japan Gastric Cancer Association after publication of the previous version. It remains largely conformed to the textbook style, but a new section has summarized 7 clinical questions to address some important clinical issues for which hard evidence is unavailable. These questions makes the basic principles for the treatment of gastric cancer and the concept more scientific and accurate. It will provide important guidance for the future clinical practice. We provided additional comments and deeply interpreted the questions proposed by the guideline according to some new research and our clinical experience.
Explanation of the 7 Clinical Questions in Japanese Gastric Cancer Treatment Guidelines of Version 4, Journal of Surgery.
Vol. 6, No. 5,
2018, pp. 112-115.
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sasako M, Sano T, Yamamoto S, Kurokawa Y, Nashimoto A, Kurita A, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. The New England journal of medicine. 2008; 359:453-62.
Tsuburaya A, Mizusawa J, Tanaka Y, Fukushima N, Nashimoto A, Sasako M, et al. Neoadjuvant chemotherapy with S-1 and cisplatin followed by D2 gastrectomy with para-aortic lymph node dissection for gastric cancer with extensive lymph node metastasis. The British journal of surgery. 2014; 101:653-60.
Svatek RS, Dinney CP. Words of wisdom. Re: D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. European urology. 2009; 56:745-6.
Sakamoto Y, Sano T, Shimada K, Esaki M, Saka M, Fukagawa T, et al. Favorable indications for hepatectomy in patients with liver metastasis from gastric cancer. Journal of surgical oncology. 2007; 95:534-9.
Takemura N, Saiura A, Koga R, Arita J, Yoshioka R, Ono Y, et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbeck's archives of surgery. 2012; 397:951-7.
Kodera Y, Ito S, Mochizuki Y, Ohashi N, Tanaka C, Kobayashi D, et al. Long-term follow up of patients who were positive for peritoneal lavage cytology: final report from the CCOG0301 study. Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 2012; 15:335-7.
Mezhir JJ, Shah MA, Jacks LM, Brennan MF, Coit DG, Strong VE. Positive peritoneal cytology in patients with gastric cancer: natural history and outcome of 291 patients. Indian journal of surgical oncology. 2011; 2:16-23.
Kinoshita T, Sasako M, Sano T, Katai H, Furukawa H, Tsuburaya A, et al. Phase II trial of S-1 for neoadjuvant chemotherapy against scirrhous gastric cancer (JCOG 0002). Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 2009; 12:37-42.
Shirao K, Boku N, Yamada Y, Yamaguchi K, Doi T, Goto M, et al. Randomized Phase III study of 5-fluorouracil continuous infusion vs. sequential methotrexate and 5-fluorouracil therapy in far advanced gastric cancer with peritoneal metastasis (JCOG0106). Japanese journal of clinical oncology. 2013; 43:972-80.
Nishina T, Boku N, Gotoh M, Shimada Y, Hamamoto Y, Yasui H, et al. Randomized phase II study of second-line chemotherapy with the best available 5-fluorouracil regimen versus weekly administration of paclitaxel in far advanced gastric cancer with severe peritoneal metastases refractory to 5-fluorouracil-containing regimens (JCOG0407). Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 2016; 19:902-10.
Okabe H, Ueda S, Obama K, Hosogi H, Sakai Y. Induction chemotherapy with S-1 plus cisplatin followed by surgery for treatment of gastric cancer with peritoneal dissemination. Annals of surgical oncology. 2009; 16:3227-36.
Tsushima T, Hironaka S, Boku N, Machida N, Yamazaki K, Yasui H, et al. Comparison of safety and efficacy of S-1 monotherapy and S-1 plus cisplatin therapy in elderly patients with advanced gastric cancer. International journal of clinical oncology. 2013; 18:10-6.
Nishikawa K, Takahashi T, Takaishi H, Miki A, Noshiro H, Yoshikawa T, et al. Phase II study of the effectiveness and safety of trastuzumab and paclitaxel for taxane- and trastuzumab-naive patients with HER2-positive, previously treated, advanced, or recurrent gastric cancer (JFMC45-1102). International journal of cancer. 2017; 140:188-96.