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Locoregional gastric cancer: a narrative review of multidisciplinary management

Gastric cancer is one of the most common cancers worldwide. While relatively uncommon in the United States, worldwide it is the 5(th) most common cancer diagnosed. Almost half of patients present with locoregional disease. Even with advanced surgical techniques and adjuvant perioperative treatment t...

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Autores principales: Pelcovits, Ari, Almhanna, Khaldoun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7575982/
https://www.ncbi.nlm.nih.gov/pubmed/33145327
http://dx.doi.org/10.21037/atm-20-3509
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author Pelcovits, Ari
Almhanna, Khaldoun
author_facet Pelcovits, Ari
Almhanna, Khaldoun
author_sort Pelcovits, Ari
collection PubMed
description Gastric cancer is one of the most common cancers worldwide. While relatively uncommon in the United States, worldwide it is the 5(th) most common cancer diagnosed. Almost half of patients present with locoregional disease. Even with advanced surgical techniques and adjuvant perioperative treatment the prognosis for patients in this cohort is still dismal. Perioperative chemotherapy and/or radiation have been used in the last several decades in an attempt to improve outcomes in locally advanced resectable gastric cancer. In this article, we will review the development of these multimodal treatment strategies over the past two to three decades. We will compare these treatment modalities and their impact on survival outcomes. We will review the evidence for perioperative chemotherapy and radiotherapy, used in isolation and in combination. We will evaluate the evidence for these various treatment strategies and discuss how this impacts the current guidelines and recommendations. While advanced locoregional gastric cancer continues to carry significant mortality, several recent studies have added to the armament of treatment options and have seen significant improvement in progression free and overall survival in this patient population. Ongoing studies into perioperative management continue to investigate alternative treatment options and best practice for locally advanced resectable gastric cancer.
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spelling pubmed-75759822020-11-02 Locoregional gastric cancer: a narrative review of multidisciplinary management Pelcovits, Ari Almhanna, Khaldoun Ann Transl Med Review Articles on Gastroesophageal Cancer 2020 Gastric cancer is one of the most common cancers worldwide. While relatively uncommon in the United States, worldwide it is the 5(th) most common cancer diagnosed. Almost half of patients present with locoregional disease. Even with advanced surgical techniques and adjuvant perioperative treatment the prognosis for patients in this cohort is still dismal. Perioperative chemotherapy and/or radiation have been used in the last several decades in an attempt to improve outcomes in locally advanced resectable gastric cancer. In this article, we will review the development of these multimodal treatment strategies over the past two to three decades. We will compare these treatment modalities and their impact on survival outcomes. We will review the evidence for perioperative chemotherapy and radiotherapy, used in isolation and in combination. We will evaluate the evidence for these various treatment strategies and discuss how this impacts the current guidelines and recommendations. While advanced locoregional gastric cancer continues to carry significant mortality, several recent studies have added to the armament of treatment options and have seen significant improvement in progression free and overall survival in this patient population. Ongoing studies into perioperative management continue to investigate alternative treatment options and best practice for locally advanced resectable gastric cancer. AME Publishing Company 2020-09 /pmc/articles/PMC7575982/ /pubmed/33145327 http://dx.doi.org/10.21037/atm-20-3509 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Articles on Gastroesophageal Cancer 2020
Pelcovits, Ari
Almhanna, Khaldoun
Locoregional gastric cancer: a narrative review of multidisciplinary management
title Locoregional gastric cancer: a narrative review of multidisciplinary management
title_full Locoregional gastric cancer: a narrative review of multidisciplinary management
title_fullStr Locoregional gastric cancer: a narrative review of multidisciplinary management
title_full_unstemmed Locoregional gastric cancer: a narrative review of multidisciplinary management
title_short Locoregional gastric cancer: a narrative review of multidisciplinary management
title_sort locoregional gastric cancer: a narrative review of multidisciplinary management
topic Review Articles on Gastroesophageal Cancer 2020
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7575982/
https://www.ncbi.nlm.nih.gov/pubmed/33145327
http://dx.doi.org/10.21037/atm-20-3509
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