Skip to main content
Erschienen in: Der Chirurg 5/2016

01.05.2016 | Magenkarzinom | Leitthema

Resektion beim fortgeschrittenen Adenokarzinom des Magens und des Ösophagus

Erweiterung der Indikation

verfasst von: Prof. Dr. S. P. Mönig, Dr. L. M. Schiffmann

Erschienen in: Die Chirurgie | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

In den aktuell gültigen deutschen S3-Leitlinien wird bei metastasierten Magenkarzinomen und metastasierten Adenokarzinomen des ösophagogastralen Übergangs eine chirurgische Therapie in der Regel nicht empfohlen. In der täglichen Praxis findet jedoch schon heute in Einzelfällen eine Erweiterung der Indikation statt, sodass auch solche Patienten in kurativer Zielsetzung im Rahmen eines multimodalen Therapiekonzepts ausgedehnt und radikal operiert werden. Diese Arbeit stellt die wissenschaftliche Rationale eines solchen Vorgehens anhand der vorliegenden Literatur und unter Einbeziehung moderner, multimodaler Konzepte dar und verweist auf Kriterien, die für eine Erweiterung der Indikation gegeben sein sollten. Bislang existieren lediglich retrospektive Untersuchungen und wenige aktuelle Metaanalysen, die eine chirurgische Behandlung bei metastasierten Adenokarzinomen rechtfertigen. Es liegen zudem erste Ergebnisse der als Abstract publizierten FLOT-3-Studie vor, die eine Patientensubgruppe identifizieren konnte, die von einer Resektion im metastasierten Stadium profitiert. Ob die chirurgische Therapie zukünftig ein fester Bestandteil in der Behandlung des begrenzt metastasierten Adenokarzinoms des Magens und des Ösophagus wird, müssen große prospektiv randomisierte Studien wie die RENAISSANCE/FLOT-5-Studie zeigen.
Literatur
1.
Zurück zum Zitat Ajani JA, Bentrem DJ, Besh S et al (2013) Gastric cancer, version 2.2013 featured updates to the NCCN guidelines. J Natl Compr Cancer Netw 11:531–546 Ajani JA, Bentrem DJ, Besh S et al (2013) Gastric cancer, version 2.2013 featured updates to the NCCN guidelines. J Natl Compr Cancer Netw 11:531–546
2.
Zurück zum Zitat Al-Batran S‑E, Hofheinz R, Homann N et al (2012) A prospective trial for defining a subset of patients with limited metastatic gastric cancer who may be candidates for bimodal treatment strategies: FLOT3. J Clin Oncol 30 (suppl–abstr 4090) Al-Batran S‑E, Hofheinz R, Homann N et al (2012) A prospective trial for defining a subset of patients with limited metastatic gastric cancer who may be candidates for bimodal treatment strategies: FLOT3. J Clin Oncol 30 (suppl–abstr 4090)
3.
Zurück zum Zitat Al-Batran SE, Hartmann JT, Probst S et al (2008) Phase III trial in metastatic gastroesophageal adenocarcinoma with Fluorouracil, eucovorin plus either Oxaliplatin or Cisplatin: A study of the AIO. J Clin Oncol 26:1435–1442CrossRefPubMed Al-Batran SE, Hartmann JT, Probst S et al (2008) Phase III trial in metastatic gastroesophageal adenocarcinoma with Fluorouracil, eucovorin plus either Oxaliplatin or Cisplatin: A study of the AIO. J Clin Oncol 26:1435–1442CrossRefPubMed
4.
Zurück zum Zitat Al-Batran SE, Pauligk C, Homann N (2013) The feasibility of triple-drug chemotherapy combination in older adult patients with oesophagogastric cancer: a randomised trial of the AIO. Eur J Cancer 49:835–842CrossRefPubMed Al-Batran SE, Pauligk C, Homann N (2013) The feasibility of triple-drug chemotherapy combination in older adult patients with oesophagogastric cancer: a randomised trial of the AIO. Eur J Cancer 49:835–842CrossRefPubMed
5.
Zurück zum Zitat Andreou A, Viganò L, Zimmitti G et al (2014) Response to preoperative chemotherapy predicts survival in patients undergoing Hepatectomy for liver metastases from gastric and esophageal cancer. J Gastrointest Surg 18:1974–1986CrossRefPubMed Andreou A, Viganò L, Zimmitti G et al (2014) Response to preoperative chemotherapy predicts survival in patients undergoing Hepatectomy for liver metastases from gastric and esophageal cancer. J Gastrointest Surg 18:1974–1986CrossRefPubMed
6.
Zurück zum Zitat Becker K, Langer R, Reim D et al (2011) Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas. Ann Surg 253:934–939CrossRefPubMed Becker K, Langer R, Reim D et al (2011) Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas. Ann Surg 253:934–939CrossRefPubMed
7.
Zurück zum Zitat Biffi R, Fazio N, Luca F et al (2010) Surgical outcome after docetaxel-based neoadjuvant chemotherapy in locally-advanced gastric cancer. World J Gastroenterol 16:868–874PubMedPubMedCentral Biffi R, Fazio N, Luca F et al (2010) Surgical outcome after docetaxel-based neoadjuvant chemotherapy in locally-advanced gastric cancer. World J Gastroenterol 16:868–874PubMedPubMedCentral
8.
Zurück zum Zitat Chang YR, Han DS, Kong SH et al (2012) The value of palliative gastrectomy in gastric cancer with distant metastasis. Ann Surg Oncol 19:1231–1239CrossRefPubMed Chang YR, Han DS, Kong SH et al (2012) The value of palliative gastrectomy in gastric cancer with distant metastasis. Ann Surg Oncol 19:1231–1239CrossRefPubMed
9.
Zurück zum Zitat Chen L, Song MQ, Lin HZ, Hao LH (2013) Chemotherapy and resection for gastric cancer with synchronous liver metastases. World J Gastroenterol 19:2097–2103CrossRefPubMedPubMedCentral Chen L, Song MQ, Lin HZ, Hao LH (2013) Chemotherapy and resection for gastric cancer with synchronous liver metastases. World J Gastroenterol 19:2097–2103CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Chen S, Li Y‑F, Feng X‑Y et al (2012) Significance of palliative gastrectomy for late-stage gastric cancer patients. J Surg Oncol 106:862–871CrossRefPubMed Chen S, Li Y‑F, Feng X‑Y et al (2012) Significance of palliative gastrectomy for late-stage gastric cancer patients. J Surg Oncol 106:862–871CrossRefPubMed
11.
Zurück zum Zitat Cheon SH, Rha SY, Jeung HC et al (2008) Survival benefit of combined curative resection of the stomach [D2 resection] and liver in gastric cancer patients with liver metastases. Ann Oncol 19:1146–1153CrossRefPubMed Cheon SH, Rha SY, Jeung HC et al (2008) Survival benefit of combined curative resection of the stomach [D2 resection] and liver in gastric cancer patients with liver metastases. Ann Oncol 19:1146–1153CrossRefPubMed
12.
Zurück zum Zitat Dittmar Y, Altendorf-Hofmann A, Rauchfuss F et al (2011) Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature. Gastric Cancer 15:131–136CrossRefPubMed Dittmar Y, Altendorf-Hofmann A, Rauchfuss F et al (2011) Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature. Gastric Cancer 15:131–136CrossRefPubMed
13.
Zurück zum Zitat Dittmar Y, Rauchfuss F, Goetz M, Jandt K (2012) Non-curative gastric resection for patients with stage 4 gastric cancer–a single center experience and current review of literature – Springer. Langenbeck’s Arch Surg 397:745–753CrossRef Dittmar Y, Rauchfuss F, Goetz M, Jandt K (2012) Non-curative gastric resection for patients with stage 4 gastric cancer–a single center experience and current review of literature – Springer. Langenbeck’s Arch Surg 397:745–753CrossRef
14.
Zurück zum Zitat Fitzgerald TL, Brinkley J, Banks S et al (2014) The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review. Langenbeck’s Arch Surg 399:989–1000CrossRef Fitzgerald TL, Brinkley J, Banks S et al (2014) The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review. Langenbeck’s Arch Surg 399:989–1000CrossRef
15.
Zurück zum Zitat Gadde R, Tamariz L, Hanna M et al (2015) Metastatic gastric cancer [MGC] patients: Can we improve survival by metastasectomy? A systematic review and meta-analysis. J Surg Oncol 112:38–45CrossRefPubMed Gadde R, Tamariz L, Hanna M et al (2015) Metastatic gastric cancer [MGC] patients: Can we improve survival by metastasectomy? A systematic review and meta-analysis. J Surg Oncol 112:38–45CrossRefPubMed
16.
Zurück zum Zitat Geh JI, Glynne-Jones R, Kwok QSK et al (2000) Preoperative ECF chemotherapy in gastro-oesophageal adenocarcinoma. Clin Oncol 12:182–187 Geh JI, Glynne-Jones R, Kwok QSK et al (2000) Preoperative ECF chemotherapy in gastro-oesophageal adenocarcinoma. Clin Oncol 12:182–187
17.
Zurück zum Zitat Glehen O, Gilly FN, Arvieux C et al (2010) Peritoneal carcinomatosis from gastric cancer: A multi-institutional study of 159 patients treated by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy. Ann Surg Oncol 17:2370–2377CrossRefPubMed Glehen O, Gilly FN, Arvieux C et al (2010) Peritoneal carcinomatosis from gastric cancer: A multi-institutional study of 159 patients treated by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy. Ann Surg Oncol 17:2370–2377CrossRefPubMed
18.
Zurück zum Zitat Hartgrink HH, Putter H (2002) Value of palliative resection in gastric cancer. Br J Surg 89:1438–1443CrossRefPubMed Hartgrink HH, Putter H (2002) Value of palliative resection in gastric cancer. Br J Surg 89:1438–1443CrossRefPubMed
19.
Zurück zum Zitat Homann N, Pauligk C, Luley K et al (2011) Pathological complete remission in patients with oesophagogastric cancer receiving preoperative 5‑fluorouracil, oxaliplatin and docetaxel. Int J Cancer 130:1706–1713CrossRefPubMed Homann N, Pauligk C, Luley K et al (2011) Pathological complete remission in patients with oesophagogastric cancer receiving preoperative 5‑fluorouracil, oxaliplatin and docetaxel. Int J Cancer 130:1706–1713CrossRefPubMed
20.
Zurück zum Zitat Ikeguchi M, Oka A, Tsujitani S et al (1994) Relationship between area of serosal invasion and intraperitoneal free cancer cells in patients with gastric cancer. Anticancer Res 14:2131–2134PubMed Ikeguchi M, Oka A, Tsujitani S et al (1994) Relationship between area of serosal invasion and intraperitoneal free cancer cells in patients with gastric cancer. Anticancer Res 14:2131–2134PubMed
21.
Zurück zum Zitat Zhai J, Li JH, Zhai RJ (2012) Predictive factors improving survival after gastric and hepatic surgical treatment in gastric cancer patients with synchronous liver metastases. Chin Med J 125:165–171PubMed Zhai J, Li JH, Zhai RJ (2012) Predictive factors improving survival after gastric and hepatic surgical treatment in gastric cancer patients with synchronous liver metastases. Chin Med J 125:165–171PubMed
22.
Zurück zum Zitat Kim KH, Lee KW, Baek SK et al (2011) Survival benefit of gastrectomy±metastasectomy in patients with metastatic gastric cancer receiving chemotherapy. Gastric Cancer 14:130–138CrossRefPubMed Kim KH, Lee KW, Baek SK et al (2011) Survival benefit of gastrectomy±metastasectomy in patients with metastatic gastric cancer receiving chemotherapy. Gastric Cancer 14:130–138CrossRefPubMed
23.
Zurück zum Zitat Kunieda K, Saji S, Sugiyama Y et al (2002) Evaluation of treatment for synchronous hepatic metastases from gastric cancer with special reference to long-term survivors. Surg Today 32:587–593CrossRefPubMed Kunieda K, Saji S, Sugiyama Y et al (2002) Evaluation of treatment for synchronous hepatic metastases from gastric cancer with special reference to long-term survivors. Surg Today 32:587–593CrossRefPubMed
24.
Zurück zum Zitat Lee JH, Paik YH, Lee JS et al (2006) Candidates for curative resection in advanced gastric cancer patients who had equivocal para-aortic lymph node metastasis on computed tomographic scan. Ann Surg Oncol 13:1163–1167CrossRefPubMed Lee JH, Paik YH, Lee JS et al (2006) Candidates for curative resection in advanced gastric cancer patients who had equivocal para-aortic lymph node metastasis on computed tomographic scan. Ann Surg Oncol 13:1163–1167CrossRefPubMed
25.
Zurück zum Zitat Lordick F (2012) To resect or not resect in metastatic gastric cancer: that is the question! Gastric Cancer 15:229–231CrossRefPubMed Lordick F (2012) To resect or not resect in metastatic gastric cancer: that is the question! Gastric Cancer 15:229–231CrossRefPubMed
26.
Zurück zum Zitat Lorenzen S, Brücher B, Zimmermann F et al (2008) Neoadjuvant continuous infusion of weekly 5‑fluorouracil and escalating doses of oxaliplatin plus concurrent radiation in locally advanced oesophageal squamous cell carcinoma: results of a phase I/II trial. Br J Cancer 99:1020–1026CrossRefPubMedPubMedCentral Lorenzen S, Brücher B, Zimmermann F et al (2008) Neoadjuvant continuous infusion of weekly 5‑fluorouracil and escalating doses of oxaliplatin plus concurrent radiation in locally advanced oesophageal squamous cell carcinoma: results of a phase I/II trial. Br J Cancer 99:1020–1026CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Lorenzen S, Pauligk C, Homann N (2013) Feasibility of perioperative chemotherapy with infusional 5‑FU, leucovorin, and oxaliplatin with [FLOT] or without [FLO] docetaxel in elderly patients with locally advanced esophagogastric cancer. Br J Cancer 108:519–526CrossRefPubMedPubMedCentral Lorenzen S, Pauligk C, Homann N (2013) Feasibility of perioperative chemotherapy with infusional 5‑FU, leucovorin, and oxaliplatin with [FLOT] or without [FLO] docetaxel in elderly patients with locally advanced esophagogastric cancer. Br J Cancer 108:519–526CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Makino H, Kunisaki C, Izumisawa Y et al (2010) Indication for hepatic resection in the treatment of liver metastasis from gastric cancer. Anticancer Res 30:2367–2376PubMed Makino H, Kunisaki C, Izumisawa Y et al (2010) Indication for hepatic resection in the treatment of liver metastasis from gastric cancer. Anticancer Res 30:2367–2376PubMed
29.
Zurück zum Zitat Martella L, Bertozzi S, Londero AP et al (2015) Surgery for liver metastases from gastric cancer. Medicine (Baltimore) 94:1–9CrossRef Martella L, Bertozzi S, Londero AP et al (2015) Surgery for liver metastases from gastric cancer. Medicine (Baltimore) 94:1–9CrossRef
30.
Zurück zum Zitat Miki Y, Fujitani K, Hirao M et al (2012) Significance of surgical treatment of liver metastases from gastric cancer. Anticancer Res 32:665–670PubMed Miki Y, Fujitani K, Hirao M et al (2012) Significance of surgical treatment of liver metastases from gastric cancer. Anticancer Res 32:665–670PubMed
31.
Zurück zum Zitat Moehler M, Al-Batran SE, Andus T et al (2011) S3-Leitlinie „Magenkarzinom“ – Diagnostik und Therapie der Adenokarzinome des Magens und ösophagogastralen Übergangs. Z Gastroenterol 49:461–531CrossRefPubMed Moehler M, Al-Batran SE, Andus T et al (2011) S3-Leitlinie „Magenkarzinom“ – Diagnostik und Therapie der Adenokarzinome des Magens und ösophagogastralen Übergangs. Z Gastroenterol 49:461–531CrossRefPubMed
32.
Zurück zum Zitat Mohri Y, Tanaka K, Ohi M et al (2014) Identification of prognostic factors and surgical indications for metastatic gastric cancer. Cancer 14:1–10 Mohri Y, Tanaka K, Ohi M et al (2014) Identification of prognostic factors and surgical indications for metastatic gastric cancer. Cancer 14:1–10
33.
Zurück zum Zitat Okuyama K, Isono K, Juan I‑K et al (1985) Evaluation of treatment for gastric cancer with liver metastasis. Cancer 55:2498–2505CrossRefPubMed Okuyama K, Isono K, Juan I‑K et al (1985) Evaluation of treatment for gastric cancer with liver metastasis. Cancer 55:2498–2505CrossRefPubMed
34.
Zurück zum Zitat Oyama K, Fushida S, Kinoshita J et al (2011) Efficacy of pre-operative chemotherapy with docetaxel, cisplatin, and S‑1 [DCS therapy] and curative resection for gastric cancer with pathologically positive para-aortic lymph nodes. J Surg Oncol 105:535–541CrossRefPubMed Oyama K, Fushida S, Kinoshita J et al (2011) Efficacy of pre-operative chemotherapy with docetaxel, cisplatin, and S‑1 [DCS therapy] and curative resection for gastric cancer with pathologically positive para-aortic lymph nodes. J Surg Oncol 105:535–541CrossRefPubMed
35.
Zurück zum Zitat Pauligk C, Meiler J et al (2013) Interim safety analysis of a phase III trial with 5‑FU, oxaliplatin, and docetaxel [FLOT] versus epirubicin, cisplatin, and 5‑FU [ECF] in patients with locally advanced, resectable gastric/oesophagogastric junction [OGJ] cancer: The AIO-sto-0210 FLOT4 study. J Clin Oncol 31: (suppl–abstr 4079) Pauligk C, Meiler J et al (2013) Interim safety analysis of a phase III trial with 5‑FU, oxaliplatin, and docetaxel [FLOT] versus epirubicin, cisplatin, and 5‑FU [ECF] in patients with locally advanced, resectable gastric/oesophagogastric junction [OGJ] cancer: The AIO-sto-0210 FLOT4 study. J Clin Oncol 31: (suppl–abstr 4079)
36.
Zurück zum Zitat Pauligk C, Tannapfel A, Meiler J et al (2015) Pathological response to neoadjuvant 5‑FU, oxaliplatin, and docetaxel [FLOT] versus epirubicin, cisplatin, and 5‑FU [ECF] in patients with locally advanced, resectable gastric/esophagogastric junction [EGJ] cancer: Data from the phase II part of the FLOT4 phase III study of the AIO. Am Soc Clin Oncol Meet Abstr 33:4016 Pauligk C, Tannapfel A, Meiler J et al (2015) Pathological response to neoadjuvant 5‑FU, oxaliplatin, and docetaxel [FLOT] versus epirubicin, cisplatin, and 5‑FU [ECF] in patients with locally advanced, resectable gastric/esophagogastric junction [EGJ] cancer: Data from the phase II part of the FLOT4 phase III study of the AIO. Am Soc Clin Oncol Meet Abstr 33:4016
37.
Zurück zum Zitat Petrelli F, Coinu A, Cabiddu M et al (2015) Hepatic resection for gastric cancer liver metastases: A systematic review and meta-analysis. J Surg Oncol 111:1021–1027CrossRefPubMed Petrelli F, Coinu A, Cabiddu M et al (2015) Hepatic resection for gastric cancer liver metastases: A systematic review and meta-analysis. J Surg Oncol 111:1021–1027CrossRefPubMed
38.
Zurück zum Zitat Porschen R, Buck A, Fischbach W et al (2015) S3-Leitlinie Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus. Z Gastroenterol 53:1288–1347CrossRefPubMed Porschen R, Buck A, Fischbach W et al (2015) S3-Leitlinie Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus. Z Gastroenterol 53:1288–1347CrossRefPubMed
39.
Zurück zum Zitat Sadeghi B, Arvieux C, Glehen O et al (2000) Peritoneal carcinomatosis from non-gynecologic malignancies. Cancer 88:358–363CrossRefPubMed Sadeghi B, Arvieux C, Glehen O et al (2000) Peritoneal carcinomatosis from non-gynecologic malignancies. Cancer 88:358–363CrossRefPubMed
40.
Zurück zum Zitat Scaringi S, Kianmanesh R, Sabate JM et al (2008) Advanced gastric cancer with or without peritoneal carcinomatosis treated with hyperthermic intraperitoneal chemotherapy: A single western center experience. Eur J Surg Oncol 34:1246–1252CrossRefPubMed Scaringi S, Kianmanesh R, Sabate JM et al (2008) Advanced gastric cancer with or without peritoneal carcinomatosis treated with hyperthermic intraperitoneal chemotherapy: A single western center experience. Eur J Surg Oncol 34:1246–1252CrossRefPubMed
41.
Zurück zum Zitat Schulz C, Kullmann F, Kunzmann V et al (2012) Multicenter phase II study of perioperative chemotherapy in resectable adenocarcinoma of the gastroesophageal junction or gastric adenocarcinoma. J Clin Oncol 30: (suppl–abstr 4072) Schulz C, Kullmann F, Kunzmann V et al (2012) Multicenter phase II study of perioperative chemotherapy in resectable adenocarcinoma of the gastroesophageal junction or gastric adenocarcinoma. J Clin Oncol 30: (suppl–abstr 4072)
42.
Zurück zum Zitat Schulz C, Kullmann F, Kunzmann V et al (2015) NeoFLOT: Multicenter phase II study of perioperative chemotherapy in resectable adenocarcinoma of the gastroesophageal junction or gastric adenocarcinoma-very good response predominantly in patients with intestinal type tumors. Int J Cancer 137:678–685CrossRefPubMed Schulz C, Kullmann F, Kunzmann V et al (2015) NeoFLOT: Multicenter phase II study of perioperative chemotherapy in resectable adenocarcinoma of the gastroesophageal junction or gastric adenocarcinoma-very good response predominantly in patients with intestinal type tumors. Int J Cancer 137:678–685CrossRefPubMed
43.
Zurück zum Zitat Sougioultzis S, Syrios J, Xynos ID et al (2011) Palliative gastrectomy and other factors affecting overall survival in stage IV gastric adenocarcinoma patients receiving chemotherapy: A retrospective analysis. Eur J Surg Oncol 37:312–318CrossRefPubMed Sougioultzis S, Syrios J, Xynos ID et al (2011) Palliative gastrectomy and other factors affecting overall survival in stage IV gastric adenocarcinoma patients receiving chemotherapy: A retrospective analysis. Eur J Surg Oncol 37:312–318CrossRefPubMed
44.
Zurück zum Zitat Starling N, Okines A, Cunningham D et al (2009) A phase II trial of preoperative chemotherapy with epirubicin, cisplatin and capecitabine for patients with localised gastro-oesophageal junctional adenocarcinoma. Br J Cancer 100:1725–1730CrossRefPubMedPubMedCentral Starling N, Okines A, Cunningham D et al (2009) A phase II trial of preoperative chemotherapy with epirubicin, cisplatin and capecitabine for patients with localised gastro-oesophageal junctional adenocarcinoma. Br J Cancer 100:1725–1730CrossRefPubMedPubMedCentral
45.
Zurück zum Zitat Takeda J, Yasumoto K, Yano S (1990) Retrospective studies of gastric cancer with hepatic metastases. Kurume Med J 37:271–276CrossRefPubMed Takeda J, Yasumoto K, Yano S (1990) Retrospective studies of gastric cancer with hepatic metastases. Kurume Med J 37:271–276CrossRefPubMed
46.
Zurück zum Zitat Thuss-Patience PC, Hofheinz RD, Arnold D et al (2012) Perioperative chemotherapy with docetaxel, cisplatin and capecitabine [DCX] in gastro-oesophageal adenocarcinoma: a phase II study of the Arbeitsgemeinschaft Internistische Onkologie [AIO]. Ann Oncol 23:2827–2834CrossRefPubMed Thuss-Patience PC, Hofheinz RD, Arnold D et al (2012) Perioperative chemotherapy with docetaxel, cisplatin and capecitabine [DCX] in gastro-oesophageal adenocarcinoma: a phase II study of the Arbeitsgemeinschaft Internistische Onkologie [AIO]. Ann Oncol 23:2827–2834CrossRefPubMed
47.
Zurück zum Zitat Tiberio G, Coniglio A, Marchet A, Marrelli D (2009) Metachronous hepatic metastases from gastric carcinoma: a multicentric survey. Eur J Cancer Surg 35:486–491 Tiberio G, Coniglio A, Marchet A, Marrelli D (2009) Metachronous hepatic metastases from gastric carcinoma: a multicentric survey. Eur J Cancer Surg 35:486–491
48.
Zurück zum Zitat Tiberio GAM, Baiocchi GL, Morgagni P et al (2014) Gastric cancer and synchronous hepatic metastases: is it possible to recognize candidates to R0 resection? Ann Surg Oncol 22:589–596CrossRefPubMed Tiberio GAM, Baiocchi GL, Morgagni P et al (2014) Gastric cancer and synchronous hepatic metastases: is it possible to recognize candidates to R0 resection? Ann Surg Oncol 22:589–596CrossRefPubMed
49.
Zurück zum Zitat Ueda K, Iwahashi M, Nakamori M, Nakamura M (2009) Analysis of the prognostic factors and evaluation of surgical treatment for synchronous liver metastases from gastric cancer. Langenbeck’s Arch Surg 394:647–653CrossRef Ueda K, Iwahashi M, Nakamori M, Nakamura M (2009) Analysis of the prognostic factors and evaluation of surgical treatment for synchronous liver metastases from gastric cancer. Langenbeck’s Arch Surg 394:647–653CrossRef
50.
Zurück zum Zitat Yang SW, Kim MG, Lee JH (2013) Role of Metastasectomy on overall survival of patients with metastatic gastric cancer. J Gastric Cancer 13:227–231CrossRef Yang SW, Kim MG, Lee JH (2013) Role of Metastasectomy on overall survival of patients with metastatic gastric cancer. J Gastric Cancer 13:227–231CrossRef
51.
Zurück zum Zitat Yang X‑J, Huang C‑Q, Suo T et al (2011) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial. Ann Surg Oncol 18:1575–1581CrossRefPubMedPubMedCentral Yang X‑J, Huang C‑Q, Suo T et al (2011) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial. Ann Surg Oncol 18:1575–1581CrossRefPubMedPubMedCentral
52.
Zurück zum Zitat Yonemura Y, Kawamura T, Bandou E et al (2005) Treatment of peritoneal dissemination from gastric cancer by peritonectomy and chemohyperthermic peritoneal perfusion. Br J Surg 92:370–375CrossRefPubMed Yonemura Y, Kawamura T, Bandou E et al (2005) Treatment of peritoneal dissemination from gastric cancer by peritonectomy and chemohyperthermic peritoneal perfusion. Br J Surg 92:370–375CrossRefPubMed
53.
Zurück zum Zitat Yoshida M, Ohtsu A, Boku N et al (2004) Long-term survival and prognostic factors in patients with metastatic gastric cancers treated with chemotherapy in the japan clinical oncology group [JCOG] study. Jpn J Clin Oncol 34:654–659CrossRefPubMed Yoshida M, Ohtsu A, Boku N et al (2004) Long-term survival and prognostic factors in patients with metastatic gastric cancers treated with chemotherapy in the japan clinical oncology group [JCOG] study. Jpn J Clin Oncol 34:654–659CrossRefPubMed
Metadaten
Titel
Resektion beim fortgeschrittenen Adenokarzinom des Magens und des Ösophagus
Erweiterung der Indikation
verfasst von
Prof. Dr. S. P. Mönig
Dr. L. M. Schiffmann
Publikationsdatum
01.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Chirurgie / Ausgabe 5/2016
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-016-0183-4

Weitere Artikel der Ausgabe 5/2016

Der Chirurg 5/2016 Zur Ausgabe

Passend zum Thema

ANZEIGE

Synergien nutzen gegen Tumore

Lungen- und Magentumore können dank Immuntherapien deutlich besser behandelt werden. Dennoch kommt es trotzdem weiterhin häufig zum Krankheitsprogress. Welche Therapieoptionen sich in der Zweitlinie am besten eignen, haben wir für Sie zusammengefasst.

ANZEIGE

Darmkrebsreihenuntersuchungen zeigen EU-weit Erfolge

In Europa haben viele Länder dem Darmkrebs mit Hilfe von Früherkennungsprogrammen den Kampf angesagt. Es gibt einen deutlichen Zusammenhang zwischen Inzidenz und Mortalität von Darmkrebs und der Zeitspanne seit Einführung von Reihenuntersuchungen.

ANZEIGE

GI-Tumore und die Rolle von Angiogenesehemmern

Content Hub

Entdecken Sie mit praxisrelevanten Patientenfällen, kompakten Studieninhalten, informativen Experteninterviews und weiteren spannenden Inhalten, wie Sie den vielseitigen Herausforderungen bei GI-Tumoren begegnen können. Hier erfahren Sie mehr! PP-RB-DE-2009