Progress and prospect of surgical comprehensive treatment of gastric cancer

doi:10.16139/j.1007-9610.2023.01.01

Abstract

Abstract:

Gastric cancer is one of the leading malignancies in China and in the world. Surgery is still the most important modality to cure gastric cancer. A series of clinical researches changed the traditional concept of surgery and avoided blindly expanding the scope of surgery. Laparoscopic surgery for both early and locally advanced gastric cancer achieved the same radical effect as open surgery. The key to further improve the efficacy of minimally invasive surgery is controlling indications, establishing a training system for surgical techniques and optimizing the relation between costs and benefits. The relationship between resection of organs and preservation of organ function should be balanced in the extended surgery for gastric cancer. Perioperative treatment of locally advanced gastric cancer would be advocated actively. Conversion therapy preoperatively for far-advanced gastric cancer is advocated. Palliative resection should be strictly controlled for the patients of far-advanced gastric cancer with extensive metastasis, and comprehensive treatment should be carried to prolong the life of patients.

Key words: Gastric cancer, Surgical treatment, Perioperative therapy

CLC Number:

R735.2

ZHU Zhenggang. Progress and prospect of surgical comprehensive treatment of gastric cancer[J]. Journal of Surgery Concepts & Practice, 2023, 28(01): 1-6.

References 40

[1]	HARTGRINK H H, VAN DE VELDE C J, PUTTER H, et al. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch Gastric Cancer Group trial[J]. J Clin Oncol, 2004, 22(11):2069-2077. doi: 10.1200/JCO.2004.08.026 pmid: 15082726
[2]	SONGUN I, PUTTER H, KRANENBARG E M, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial[J]. Lancet Oncol, 2010, 11(5):439-449. doi: 10.1016/S1470-2045(10)70070-X pmid: 20409751
[3]	SASAKO M, SANO T, YAMAMOTO S, et al. Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomized controlled trial[J]. Lancet Oncol, 2006, 7(8):644-651. doi: 10.1016/S1470-2045(06)70766-5 URL
[4]	SASAKO M, SANO T, YAMAMOTO S, et al. D2 lympha-denectomy alone or with para-aortic nodal dissection for gastric cancer[J]. N Engl J Med, 2008, 359(5):453-462. doi: 10.1056/NEJMoa0707035 URL
[5]	SANO T, SASAKO M, MIZUSAWA J, et al. Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma[J]. Ann Surg, 2017, 265(2):277-283. doi: 10.1097/SLA.0000000000001814 pmid: 27280511
[6]	KUROKAWA Y, DOKI Y, MIZUSAWA J, et al. Bursectomy versus omentectomy alone for resectable gastric cancer (JCOG1001): a phase 3, open-label, randomised controlled trial[J]. Lancet Gastroenterol Hepatol, 2018, 3(7):460-468. doi: 10.1016/S2468-1253(18)30090-6 URL
[7]	KIM H H, HAN S U, KIM M C, et al. Effect of laparoscopic distal gastrectomy vs. open distal gastrectomy on long-term survival among patients with stage Ⅰgastric cancer: the KLASS-01 randomized clinical trial[J]. JAMA Oncol, 2019, 5(4):506-513. doi: 10.1001/jamaoncol.2018.6727 URL
[8]	HYUNG W J, YANG H K, PARK Y K, et al. Long-term outcomes of laparoscopic distal gastrectomy for locally advanced gastric cancer: the KLASS-02-RCT randomized clinical trial[J]. J Clin Oncol, 2020, 38(28):3304-3313. doi: 10.1200/JCO.20.01210 pmid: 32816629
[9]	KATAI H, MIZUSAWA J, KATAYAMA H, et al. Survival outcomes after laparoscopy-assisted distal gastrectomy versus open distal gastrectomy with nodal dissection for clinical stage ⅠA or ⅠB gastric cancer (JCOG0912): a multicentre, non-inferiority, phase 3 randomised controlled trial[J]. Lancet Gastroenterol Hepatol, 2020, 5(2):142-151. doi: 10.1016/S2468-1253(19)30332-2 URL
[10]	YU J, HUANG C, SUN Y, et al. Effect of laparoscopic vs. open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: the CLASS-01 randomized clinical trial[J]. JAMA, 2019, 321(20):1983-1992. doi: 10.1001/jama.2019.5359 URL
[11]	LIU F, HUANG C, XU Z, et al. Morbidity and mortality of laparoscopic vs. open total gastrectomy for clinical stageⅠgastric cancer: the CLASS02 multicenter randomized clinical trial[J]. JAMA Oncol, 2020, 6(10):1590-1597. doi: 10.1001/jamaoncol.2020.3152 URL
[12]	LI Z, SHAN F, YING X, et al. Assessment of laparoscopic distal gastrectomy after neoadjuvant chemotherapy for locally advanced gastric cancer: a randomized clinical trial[J]. JAMA Surg, 2019, 154 (12):1093-1101. doi: 10.1001/jamasurg.2019.3473 pmid: 31553463
[13]	CHEN Q Y, XIE J W, ZHONG Q, et al. Safety and efficacy of indocyanine green tracer-guided lymph node dissection during laparoscopic radical gastrectomy in patients with gastric cancer: a randomized clinical trial[J]. JAMA Surg, 2020, 155(4):300-311. doi: 10.1001/jamasurg.2019.6033 URL
[14]	姚学新, 严超, 燕敏, 等. 胃癌D_2根治术联合脾切除与否对疗效影响的比较研究[J]. 中华胃肠外科杂志, 2010, 13(2):111-114.
	YAO X X, YAN C, YAN M, et al. A comparative study on the efficacy of spleen-preserving modified D_2 radical gastrectomy and D_2 radical gastrectomy with splenectomy[J]. Chin J Gastrointest Surg, 2010, 13(2):111-114.
[15]	何晓生, 吴小剑, 汪建平, 等. 胃癌根治术腹主动脉旁淋巴结清扫安全性与有效性的Meta分析[J]. 中华胃肠外科杂志, 2010, 13(2):119-124.
	HE X S, WU X J, WANG J P, et al. Meta-analysis of safety and efficacy on paraaortic lymphadenectomy in gastric cancer[J]. Chin J Gastrointest Surg, 2010, 13(2):119-124.
[16]	NAUM C, BÎRLĂ R, MARICA D C, et al. In search of the optimal reconstruction method after total gastrectomy. is Roux-en-Y the best? A review of the randomized clinical trials[J]. Chirurgia, 2020, 115(1):12-22. doi: 10.21614/chirurgia.115.1.12 URL
[17]	ZHAO L, LING R, CHEN J, et al. Clinical outcomes of proximal gastrectomy versus total gastrectomy for proximal gastric cancer: a systematic review and meta-analysis[J]. Dig Surg, 2021, 38(1):1-13. doi: 10.1159/000506104 URL
[18]	CUNNINGHAM D, ALLUM W H, STENNING S P, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer[J]. N Engl J Med, 2006, 355(1):11-20. doi: 10.1056/NEJMoa055531 URL
[19]	YCHOU M, BOIGE V, PIGNON J P, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phaseⅢtrial[J]. J Clin Oncol, 2011, 29(13):1715-1721.
[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[J]. Lancet, 2019, 393(10184):1948-1957. doi: 10.1016/S0140-6736(18)32557-1 URL
[21]	KANG Y K, YOOK J H, PARK Y K, et al. PRODIGY: a phase Ⅲ study of neoadjuvant docetaxel, oxaliplatin, and S-1 plus surgery and adjuvant S-1 versus surgery and adjuvant S-1 for resectable advanced gastric cancer[J]. J Clin Oncol, 2021, 39(26):2903-2913. doi: 10.1200/JCO.20.02914 URL
[22]	ZHANG X, LIANG H, LI Z, et al. Perioperative or post-operative adjuvant oxaliplatin with S-1 versus adjuvant oxaliplatin with capecitabine in patients with locally advanced gastric or gastro-oesophageal junction adenocarcinoma undergoing D2 gastrectomy (RESOLVE): an open-label, superiority and non-inferiority, phase 3 randomised controlled trial[J]. Lancet Oncol, 2021, 22(8):1081-1092. doi: 10.1016/S1470-2045(21)00297-7 URL
[23]	丁学伟, 郑志超, 赵群, 等. 基于多中心真实世界数据的胃癌围手术期化疗患者生存分析[J]. 中华胃肠外科杂志, 2021, 24(5):403-412.
	DING X W, ZHENG Z C, ZHAO Q, et al. A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data[J]. Chin J Gastrointest Surg, 2021, 24(5):403-412.
[24]	WANG F H, ZHANG X T, LI Y F, et al. The Chinese Society of Clinical Oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer, 2021[J]. Cancer Commun (Lond), 2021, 41(8):747-795.
[25]	GAO X, ZHANG Y, YUAN F, et al. Locally advanced gastric cancer: total iodine uptake to predict the response of primary lesion to neoadjuvant chemotherapy[J]. J Cancer Res Clin Oncol, 2018, 144(11):2207-2218. doi: 10.1007/s00432-018-2728-z pmid: 30094537
[26]	ZHANG Y, CHEN J, YUAN F, et al. Prognostic role of iodine values for gastric cancer after neoadjuvant chemotherapy: a strong independent prognostic factor[J]. Diagn Interv Radiol, 2022, 28(5):388-395. doi: 10.5152/dir URL
[27]	CHEN Y, YUAN F, WANG L, et al. Evaluation of dual-energy CT derived radiomics signatures in predicting outcomes in patients with advanced gastric cancer after neoadjuvant chemotherapy[J]. Eur J Surg Oncol, 2022, 48(2):339-347. doi: 10.1016/j.ejso.2021.07.014 URL
[28]	CHEN Y, XU W, LI Y L, et al. CT-based radiomics showing generalization to predict tumor regression grade for advanced gastric cancer treated with neoadjuvant chemotherapy[J]. Front Oncol, 2022, 12:758863. doi: 10.3389/fonc.2022.758863 URL
[29]	YOSHIDA K, YAMAGUCHI K, OKUMURA N, et al. Is conversion therapy possible in stage Ⅳ gastric cancer: the proposal of new biological categories of classification[J]. Gastric Cancer, 2016, 19(2):329-338. doi: 10.1007/s10120-015-0575-z URL
[30]	朱正纲. 晚期胃癌转化治疗的理念与临床意义[J]. 外科理论与实践, 2017, 22(1):1-4.
	ZHU Z G. Concept and clinical significance of conversion therapy for unresectable advanced gastric cancer[J]. J Surg Concepts Pract, 2017, 22(1):1-4.
[31]	朱正纲. 晚期胃癌转化治疗的难点、焦点与要点[J]. 外科理论与实践, 2019, 24(1):1-5.
	ZHU Z G. The difficulty and some focal points in conversion therapy for patients with far-advanced gastric cancer[J]. J Surg Concepts Pract, 2019, 24(1):1-5.
[32]	HANAHAN D. Hallmarks of cancer: new dimensions[J]. Cancer Discov, 2022, 12(1):31-46. doi: 10.1158/2159-8290.CD-21-1059 pmid: 35022204
[33]	YOSHIKAWA T, SASAKO M, YAMAMOTO S, et al. Phase Ⅱ study of neoadjuvant chemotherapy and extended surgery for locally advanced gastric cancer[J]. Br J Surg, 2009, 96(9):1015-1022. doi: 10.1002/bjs.6665 URL
[34]	TSUBURAYA A, MIZUSAWA J, TANAKA Y, 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[J]. Br J Surg, 2014, 101(6):653-660. doi: 10.1002/bjs.9484 pmid: 24668391
[35]	ZHANG K, CHEN L. Chinese consensus on the diagnosis and treatment of gastric cancer with liver metastases[J]. Ther Adv Med Oncol, 2020, 12: 1758835920904803
[36]	程向东, 季加孚. 胃癌卵巢转移诊断和治疗中国专家共识(2021版)[J]. 中国肿瘤, 2022, 31(2):81-87.
	CHENG X D, JI J F. The Chinese expert consensus on the diagnosis and treatment of ovarian metastasis from gastric cancer,2021[J]. China Cancer, 2022, 31(2):81-87.
[37]	ISHIGAMI H, FUJIWARA Y, FUKUSHIMA R, et al. Phase Ⅲ trial comparing intraperitoneal and intravenous paclitaxel plus S-1 versus cisplatin plus S-1 in patients with gastric cancer with peritoneal metastasis: PHOENIX GC trial[J]. J Clin Oncol, 2018, 36(19):1922-1929. doi: 10.1200/JCO.2018.77.8613 URL
[38]	YANG Z Y, YUAN F, LU S, et al. Efficacy and safety of conversion therapy by intraperitoneal and intravenous paclitaxel plus oral S-1 in gastric cancer patients with peritoneal metastasis: a prospective phase Ⅱ study[J]. Front Oncol, 2022, 12:905922. doi: 10.3389/fonc.2022.905922 URL
[39]	朱正纲. 胃癌腹膜转移转化性治疗的临床意义与实践要点[J]. 中华胃肠外科杂志, 2017, 20(10):1094-1098.
	ZHU Z G. Clinical significance and practice points of conversion therapy for gastric cancer with peritoneal metastasis[J]. Chin J Gastrointest Surg, 2017, 20(10):1094-1098.
[40]	朱正纲. 预防与治疗胃癌腹膜转移的若干关键问题[J]. 外科理论与实践, 2021, 26(1):1-6.
	ZHU Z G. Key issues in prevention and treatment of peritoneal metastatic gastric cancer[J]. J Surg Concepts Pract, 2021, 26(1):1-6.