演題抄録

FACO/JSCO Joint Symposium

開催概要
開催回
第54回・2016年・横浜
 

1st clinical trial: Perspective from CSCO about conventional therapy for gastric cancer

演題番号 : FAJS-3

[筆頭演者]
Ji Jiafu:1 

1:Peking University Cancer Hospital & Institute, China

 

In China, nearly 31.2% gastric cancer patients diagnosed as metastatic gastric cancer (mGC). The standard treatment of mGC has not come to concordance. The effect of surgery for mGC is under debated. On the one hand, palliative chemotherapy for mGC progressed very slowly. On the other hand, surgical skills and instruments has developed quickly. As a result, the morbidity and mortality decreased obviously in recent years, which created an opportunity for surgery in mGC patients.
Conventional therapy is regarded as to perform R0 resection after preoperative therapy for patients with potentially resectable metastatic or unresectable cancer.
The area of mGC is mainly peritoneum, No. 16 metastasis, liver and ovary. For patients with peritoneal carcinomatosis, CCOG 0301 study concluded that gastrectomy plus S-1 postoperative chemotherapy improved 5yrs overall survival rate to 20%. The study from our center also implied that cytoreductive surgery plus HIPEC improved survival for patients with peritoneal carcinomatosis. Regarding to No. 16 positive MCG patients, REGATTA subgroup analysis implied that gastrectomy might benefit patients with cN2/N3. JCOG 0405 and 0001 study results also brought us hopes of cure for mGC patients with positive bulky N2 or No. 16 lymph nodes. Concerning liver metastasis, the study from our center elucidated that preoperative followed by surgery could improve survival. As to ovary metastasis, the correlating studies were rare. Our study of heterochronous ovary metastasis concluded that ovariectomy plus HIPEC improved survival.
Recently, FACO/CONVO-GC-1 study has started. This study will clarify the question whether conventional therapy has an effective role for improving the survival of mGC patients. In the future, mGC will no longer be the forbidden zone of surgical treatment, and conventional therapy is the key of surgery for mGC.

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