Multimodality Therapy of Local-Regional Gastric Carcinoma
Gastric carcinoma is more frequent in the Orient, South America, eastern Europe, and countries of the former Soviet Union than it is in North America and western Europe. Its incidence has been declining throughout the world for the past 50 years. Screening for gastric carcinoma is performed only in Japan and then on a limited basis. Therefore, in rest of the world patients are frequently diagnosed with advanced gastric carcinoma at the outset. It had been estimated that, more than 22600 new cases of gastric cancer would be diagursed in 1998 in the United States, and 13700 deaths were expected . In Western patients the curative resection rate (R0 type surgery) can be achieved in fewer than 50% of patients [2,3]. Clearly, this low R0 resection rate in the West is due to suboptimal clinical staging and the higher stage at diagnosis. In Western countries the incidence of proximal gastric carcinoma has risen during the past 15 years, and proximal gastric carcinomas carry a worse prognosis than do distal carcinomas [4,5].
KeywordsGastric Cancer Gastric Carcinoma Preoperative Chemotherapy Gastric Adenocarcinoma Preoperative Therapy
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- 5.Philip PA, Ajani JA (1996) Gastric carcinoma. In: Pazdur R (ed) Medical oncology: a comprehensive review 2nd edn. PRR, Huntington, NY, pp 235–246Google Scholar
- 8.Mayer RJ (1988) Current issues in the treatment of patients with gastric cancer. In: Levin B (ed) Gastrointestinal cancer: current approaches to diagnosis and treatment. Austin, University of Texas Press, pp 365–379Google Scholar
- 9.Krook JE, O’Connell MJ, Wieand HS, Beart RW Jr, Leigh JE, Kugler JW, Foley JF, Pfeifle DM, Twito DI (1991) Prospective randomized evaluation of intensive course 5-fluorouracil plus doxorubicin as surgical adjuvant chemotherapy for resected gastric cancer. Cancer 67:2454–2458PubMedCrossRefGoogle Scholar
- 15.Wilke H, Preusser P, Fink U, Gunzer U, Meyer HJ, Meyer J, Siewert JR, Achterrath W, Lenaz L, Knipp H, Schmoll HJ (1989) Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. J Clin Oncol 7:1318–1326PubMedGoogle Scholar
- 17.Leichman L, Silberman H, Leichman CG, Spears CP, Ray M, Muggia FM, Kiyabu M, Radin R, Laine L, Stain S, Fuerst M, Groshen S, Donovan A (1992) Preoperative systemic chemotherapy followed by adjuvant postoperative intraperitoneal therapy for gastric cancer: a University of Southern California pilot program. J Clin Oncol 10:1933–1942PubMedGoogle Scholar
- 18.Kelsen D, Karpeh M, Schwartz G, Gerdes H, Lightdale C, Botet J, Lauers G, Klimstra D, Huang Y, Saltz L, Quan V, Brennan M (1996) Neoadjuvant therapy of high-risk gastric carcinoma: a phase II trial of preoperative FAMTX and postoperative intraperitoneal fluorouracil-cisplatin plus intravenous fluorouracil. J Clin Oncol 14:1818–1828PubMedGoogle Scholar
- 19.Ajani JA, Mansfield PF, Dumas P, Pazdur R, Evans D, Curley S, Pisters P, Lynch P, Ota D (1996) All chemotherapy preoperatively with cisplatin, 5-FU, and Intron in patients with potentially resectable gastric carcinoma. Proc ASCOGoogle Scholar
- 20.Lowy AM, Mansfield PF, Leach SD, Pazdur R, Dumas P, Ajani JA (in press) Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer. Ann SurgGoogle Scholar
- 25.Horn RC (1995) Carcinoma of the stomach: autopsy findings in untreated cases. Gastroenterology 29:515–525Google Scholar