Advertisement

The jury is still out on peri-operative vs. adjuvant chemotherapy for distal gastric cancer

Published:December 20, 2021DOI:https://doi.org/10.1016/j.amjsurg.2021.12.012
      Randomized control trials have established systemic therapy as an integral part of treatment for gastric cancer, but the ideal sequence of surgery and chemotherapy is not known. In the West, peri-operative chemotherapy (based on MAGIC and FLOT4 trials) is the standard of care vs. in the East, D2 gastrectomy followed by adjuvant chemoradiation (based on ARTIST trial) or adjuvant chemotherapy (based on S-1 and CLASSIC trials) is more common. In this issue, Singh et al. ask if perioperative chemotherapy or adjuvant chemotherapy portends a survival advantage specifically for patients with resectable distal gastric cancer who underwent D2 lymphadenectomy.
      • Singh H.K.
      • Chaudhari V.
      • Batra S.
      • et al.
      Radical D2 gastrectomy with adjuvant chemotherapy for stage IB/II/III distal gastric cancers in the era of perioperative chemotherapy: a propensity matched comparison.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Singh H.K.
        • Chaudhari V.
        • Batra S.
        • et al.
        Radical D2 gastrectomy with adjuvant chemotherapy for stage IB/II/III distal gastric cancers in the era of perioperative chemotherapy: a propensity matched comparison.
        Am J Surg. 2022; 223: 1055-1062
        • Xue J.
        • Yang H.
        • Huang S.
        • Zhou T.
        • Zhang X.
        • Zu G.
        Comparison of the overall survival of proximal and distal gastric cancer after gastrectomy: a systematic review and meta-analysis.
        World J Surg Oncol. 2021; 19: 17
        • Cunningham D.
        • Allum W.H.
        • Stenning S.P.
        • et al.
        Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer.
        N Engl J Med. 2006; 355: 11-20
        • Al-Batran S.E.
        • Homann N.
        • Pauligk C.
        • et al.
        Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial.
        Lancet. 2019; 393: 1948-1957
        • Austin P.C.
        An introduction to propensity score methods for reducing the effects of confounding in observational studies.
        Multivariate Behav Res. 2011; 46: 399-424
        • Kang Y.K.
        • Yook J.H.
        • Park Y.K.
        • et al.
        LBA41 - phase III randomized study of neoadjuvant chemotherapy (CT) with docetaxel(D), oxaliplatin(O) and S-1(S) (DOS) followed by surgery and adjuvant S-1, vs surgery and adjuvant S-1, for resectable advanced gastric cancer (GC) (PRODIGY).
        Ann Oncol. 2019; 30: v876-v877
        • Iwasaki Y.
        • Terashima M.
        • Mizusawa J.
        • et al.
        Gastrectomy with or without neoadjuvant S-1 plus cisplatin for type 4 or large type 3 gastric cancer (JCOG0501): an open-label, phase 3, randomized controlled trial.
        Gastric Cancer. 2021; 24: 492-502
        • Tokunaga M.
        • Mizusawa J.
        • Machida N.
        • et al.
        Phase III trial to evaluate the efficacy of neoadjuvant chemotherapy with S-1 plus oxaliplatin followed by D2 gastrectomy with adjuvant S-1 in locally advanced gastric cancer: Japan Clinical Oncology Group study JCOG1509 (NAGISA trial).
        J Clin Oncol. 2017; 35 (TPS4134-TPS4134)
        • Cheng J.
        • Cai M.
        • Shuai X.
        • Gao J.
        • Wang G.
        • Tao K.
        Multimodal treatments for resectable gastric cancer: a systematic review and network meta-analysis.
        Eur J Surg Oncol. 2019; 45: 1796-1805
        • Choi M.
        • Ishizawa S.
        • Kraemer D.
        • Sasson A.
        • Feinberg E.
        Perioperative chemotherapy versus adjuvant chemotherapy strategies in resectable gastric and gastroesophageal cancer: a Markov decision analysis.
        Eur J Surg Oncol. 2021;