geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

The value of adjuvant and neoadjuvant chemotherapy in treatment of stomach carcinoma


, : The value of adjuvant and neoadjuvant chemotherapy in treatment of stomach carcinoma. Wiener Klinische Wochenschrift 108(16): 496-504

The incidence of gastric adenocarcinoma has decreased dramatically in most Western countries over the past five decades. However, the five-year survival rate remains poor and late diagnosis is one of the main reasons for the lack of marked improvement in outcome. More than 50% of the patients found to have advanced local (stage T III), or systemic (stage T IV) gastric cancer at the time of diagnosis. This review article examines the current state of chemotherapeutic regimens additive to surgery, based on a computer-supported literature search (MED-LINE and CANCERLIT). Since 1980 15 randomized studies have been performed to evaluate the efficacy of systemic adjuvant chemotherapy. Of these, 13 were published in the Western English literature and 2 were Japanese studies, encompassing a total of over 2000 patients. In 3 studies adjuvant chemotherapy was administered intraperitoneally. An evaluation of these studies failed to demonstrate any advantage for the outcome of chemotherapy on patients with curative resected gastric carcinoma. Thus, according to present knowledge, this form of adjuvant treatment cannot be recommended for routine clinical management. In order to evaluate the effect of neoadjuvant chemotherapy, 17 randomized studies have been reviewed. In 6 studies (3 Western studies, 3 Japanese studies) neoadjuvant chemotherapy was investigated in patients with potentially curative resectable gastric carcinoma. 11 Western studies reported the results of neoadjuvant chemotherapy in cases of locally advanced disease. It appears that neoadjuvant chemotherapy of locally advanced non-resectable gastric cancer in patients who do not have distant metastases and/or "carcinosis peritonei" reduces tumor size in 30-40% of the patients, thus enabling radical resection in a second look operation. The efficacy of neoadjuvant chemotherapy in potentially resectable gastric carcinoma cannot be definitely assessed at the present time since only scant, preliminary findings are available. Future goals for the treatment of gastric carcinoma should include studies evaluating preoperative chemotherapy using effective, but less toxic substances, based on exact tumor-staging by means of endoluminal sonography. Furthermore, research projects investigating the value of intraperitoneal therapeutic regimens such as hyperthermic chemoperfusion or intraperitoneal instillation of the requisite substances in the prevention of intraperitoneal carcinomatosis and local recurrence will be of great importance.

US$29.90

PMID: 8967093


Other references

Sieffert, N.; Bühl, M., 2009: Noncovalent interactions in a transition-metal triphenylphosphine complex: a density functional case study. The binding enthalpy of a triphenylphosphine ligand in Ru(CO)Cl(PPh(3))(3)(CHCHPh) is studied with "standard" (BP86 and B3LYP), dispersion-corrected (B3LYP-D and B97-D), and highly parametrized (M05 and M06 series) density functionals. A...

Boxt, L.M.; Murray, P.D.; Perlmutt, L.M.; Harrington, D.P.; Sandor, T.; Monteiro, K.M.; Levin, D.C., 1985: Intravenous digital subtraction angiography in diagnosis of vascular graft occlusion. Differentiation is often difficult between vascular graft occlusion and progression of underlying disease in patients after vascular surgery. We have studied 57 patients after surgery for traumatic and atherosclerotic arterial occlusion and other...

France, E.; Gray, J.R.; Dougan, S.; Poll, A.; Gamet, K., 2000: Cancer Genetic Service in Wales Realising the potential. Journal of Medical Genetics 37(Supplement 1): S37, September

Stovbun, F.I.; Shtemberg, M.I.; Iagina, V.S.; Khubka, E.I., 1973: Microflora of the vagina in certain itching dermatoses of the genital organs. Vestnik Dermatologii i Venerologii 47(10): 81-84

Shen, L.; Siwkowski, A.; Wancewicz, E.V.; Lesnik, E.; Butler, M.; Witchell, D.; Vasquez, G.; Ross, B.; Acevedo, O.; Inamati, G.; Sasmor, H.; Manoharan, M.; Monia, B.P., 2003: Evaluation of C-5 propynyl pyrimidine-containing oligonucleotides in vitro and in vivo. Inclusion of C-5 propynyl pyrimidines in phosphorothioate antisense oligonucleotides (ASOs) has been shown to significantly increase their potency for inhibiting gene expression in vitro. This increased potency is believed to be the result of enha...

Briscoe, C.P.; Tadayyon, M.; Andrews, J.L.; Benson, W.G.; Chambers, J.K.; Eilert, M.M.; Ellis, C.; Elshourbagy, N.A.; Goetz, A.S.; Minnick, D.T.; Murdock, P.R.; Sauls, H.R.; Shabon, U.; Spinage, L.D.; Strum, J.C.; Szekeres, P.G.; Tan, K.B.; Way, J.M.; Ignar, D.M.; Wilson, S.; Muir, A.I., 2002: The orphan G protein-coupled receptor GPR40 is activated by medium and long chain fatty acids. GPR40 is a member of a subfamily of homologous G protein-coupled receptors that include GPR41 and GPR43 and that have no current function or ligand ascribed. Ligand fishing experiments in HEK293 cells expressing human GPR40 revealed that a range o...

Kim, S.; Choi, Y.; Bazer, F.W.; Spencer, T.E., 2003: Identification of genes regulated by interferon tau in the ovine endometrium that are independent of the classical JAK-STAT pathway. Biology of Reproduction 68(Supplement 1): 220

Jerlang, P., 1985: The Tübingen implant. Tidsskrift for Tandlaeger: 123-130

Bryl, E.; Vallejo, A.N.; Matteson, E.L.; Witkowski, J.M.; Weyand, C.M.; Goronzy, J.J., 2005: Modulation of CD28 expression with anti-tumor necrosis factor alpha therapy in rheumatoid arthritis. Objective. The immune system of patients with rheumatoid arthritis (RA) is characterized by the accumulation of CD4+ T cells deficient in CD28 expression and the up-regulation of tumor necrosis factor a (TNF alpha). Previous in vitro studies have...

Suzuki, H.; Twarog, B.M., 1982: Membrane properties of smooth muscle cells in pulmonary arteries of the rat. Electrical properties of the membrane of smooth muscle cells in the rat main pulmonary artery (MPA) and a small pulmonary artery (SPA) were compared. MPA and SPA differed in several important respects, suggesting characteristic quantitative and qu...