nach oben

Erschienen in:

01.12.2011 | Review

The role of neoadjuvant and adjuvant treatment for adenocarcinoma of the upper gastrointestinal tract

verfasst von: C Matuschek, E Bölke, M Peiper, WT Knoefel, W Budach, A Erhardt, A Scherer, PA Gerber, BA Buhren, N Gattermann, SE Baldus, E Rusnak, V Shukla, K Orth

Erschienen in: European Journal of Medical Research | Ausgabe 6/2011

Einloggen, um Zugang zu erhalten

Abstract

Both locally advanced adenocarcinoma of the stomach and gastro-esophageal junction are associated with poor prognosis due to the lack of effective treatment. Recently multimodal treatment consisting of neoadjuvant chemotherapy in combination with radiotherapy is reported to improve survival when compared to surgery alone. Neoadjuvant therapy in these locally advanced tumors allows for early tumor responses and the extent of tumor regression that can be achieved is considered a significant prognostic factor. This, in turn, increases the resectability of these tumors. Also due to the high frequency of lymph node metastasis, patients with locally advanced adenocarcinoma should undergo a D2 lymphadenectomy. Postoperative chemoradiation and perioperative chemotherapy have been studied in gastric adenocarcinomas and showed a survival benefit. However, the surgical techniques used in these trials are no longer considered to be standard by today's surgical practice. In addition, there are no standard recommendations for adjuvant chemotherapy or chemoradiation after R0 resection and adequate lymph node dissection.

Urschel JD, Vasan H: A meta-analysis of randomized controlled trials that compared neoadjuvant chemoradiation and surgery to surgery alone for resectable esophageal cancer. Am J Surg 2003,185(6):538–543. 10.1016/S0002-9610(03)00066-7PubMedCrossRef

Kaklamanos IG, Walker GR, Ferry K, et al.: Neoadjuvant treatment for resectable cancer of the esophagus and the gastroesophageal junction: a meta-analysis of randomized clinical trials. Ann Surg oncol 2003,10(7):754–761. 10.1245/ASO.2003.03.078PubMedCrossRef

Fiorica F, Di Bona D, Schepis F, et al.: Preoperative chemoradiotherapy for oesophageal cancer: a systematic review and meta-analysis. Gut 2004,53(7):925–930. 10.1136/gut.2003.025080PubMedCentralPubMedCrossRef

Geh JI, Bond SJ, Bentzen SM, Glynne-Jones R: Systematic overview of preoperative (neoadjuvant) chemoradiotherapy trials in oesophageal cancer: evidence of a radiation and chemotherapy dose response. Radio-ther oncol 2006,78(3):236–244.CrossRef

Gebski V, Burmeister B, Smithers BM, et al.: Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol 2007,8(3):226–234. 10.1016/S1470-2045(07)70039-6PubMedCrossRef

Arnott SJ, Duncan W, Gignoux M, et al.: Preoperative radiotherapy for esophageal carcinoma. Cochrane Database Syst Rev 2005, (4):CD001799.

Walsh TN, Noonan N, Hollywood D, et al.: A comparison of multimodal therapy and surgery for esophageal adeno-carcinoma. N Engl J Med 1996,335(7):462–467. 10.1056/NEJM199608153350702PubMedCrossRef

Stahl M, Walz MK, Stuschke M, et al.: Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adeno-carcinoma of the esophagogastric junction. J Clin Oncol 2009,27(6):851–856. 10.1200/JCO.2008.17.0506PubMedCrossRef

Medical Research Council Oesophageal Cancer Working Group: Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet 2002, 359: 1727–1733.CrossRef

10.

Cunningham D, Allum WH, Stenning SP, et al.: MAGIC Trial Participants. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006, 355: 11–20. 10.1056/NEJMoa055531PubMedCrossRef

11.

Boige V, Pignon JP, Saint-Aubert B, et al.: Final results of a randomized trial comparing preoperative 5-fluorouracil (F) cisplatin (P) to surgery alone in adeno-carcinoma of stomach and lower esophagus (ASLE): FNLCC accord 07-FFCD 9703 trial. J Clin Oncol 2007, 25: 4510.

12.

Sakuramoto S, Sasako M, Yamaguchi T, et al.: Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 2007, 357: 1810–1820. 10.1056/NEJMoa072252PubMedCrossRef

13.

Earle CC, Maroun JA: Adjuvant chemotherapy after curative resection for gastric cancer in non-Asian patients: revisiting a meta-analysis of randomized trials. Eur J Cancer 1999, 35: 1059–1064. 10.1016/S0959-8049(99)00076-3PubMedCrossRef

14.

Mari E, Floriani I, Tinazzi A, et al.: Efficacy of adjuvant chemotherapy after curative resection for gastric cancer: a meta-analysis of published randomized trials. A study of the GISCAD Ann Oncol 2000, 11: 837–843.PubMedCrossRef

15.

Janunger KG, Hafström L, Glimelius B: Chemotherapy in gastric cancer: a review and updated meta-analysis. Eur J Surg oncol 2002, 168: 597–608.CrossRef

16.

Buyse M, Pignon J: Meta-analysis of randomized trials assessing the interest of postoperative chemotherapy and prognostic factors in gastric cancer. J Clin Oncol 2009, 25: 211.

17.

Macdonald JS, Smalley SR, Benedetti J, et al.: Chemoradiotherapie after surgery compared with surgery alone for adeno-carcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001, 345: 725–730. 10.1056/NEJMoa010187PubMedCrossRef

18.

Hermans J, Bonenkamp JJ, Boon Mc, et al.: Adjuvant therapy after curative resection for gastric cancer: meta-analysis of randomized trials. J clin oncol 1993,11(8):1441–1447.PubMed

19.

Zhang ZX, Gu XZ, Yin WB, et al.: Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adeno-carcinoma of gastric cardia (AGC) - report on 370 patients. Int J Radiat Oncol Biol Phys 1998,42(5):929–934. 10.1016/S0360-3016(98)00280-6PubMedCrossRef

20.

Fiorica F, Cartei F, Enea M, et al.: The impact of radiotherapy on survival in resectable gastric carcinoma: a meta-analysis of literature data. Cancer Treat Rev 2007,33(8):729–740. 10.1016/j.ctrv.2007.08.005PubMedCrossRef

21.

Macdonald JS, Smalley SR, Benedetti J, et al.: Chemoradiotherapy after surgery compared with surgery alone for adeno-carcinoma of the stomach or gastro-esophageal junction. N Engl J Med 2001,345(10):725–730. 10.1056/NEJMoa010187PubMedCrossRef

22.

Bajetta E, Buzzoni R, Mariani L, et al.: Adjuvant chemotherapy in gastric cancer: 5-year results of a randomised study by the Italian Trials in Medical oncology (ITMO) Group. Ann Oncol 2002,13(2):299–307. 10.1093/annonc/mdf040PubMedCrossRef

23.

Bouché O, Ychou M, Burtin P, et al.: Adjuvant chemotherapy with 5-fluorouracil and cisplatin compared with surgery alone for gastric cancer: 7-year results of the FFCD randomized phase III trial (8801). Ann Oncol 2005,16(9):1488–1497. 10.1093/annonc/mdi270PubMedCrossRef

24.

Schwartz GK, Winter K, Minsky BD, et al.: Randomized phase II trial evaluating two paclitaxel and cisplatin-containing chemoradiation regiments as adjuvant therapy in resected gastric cancer (RTOG-0114). J Clin Oncol 2009, 27: 1956–1962. 10.1200/JCO.2008.20.3745PubMedCentralPubMedCrossRef

25.

Ott K, Herrmann K, Lordick F, Wieder H, et al.: Early metabolic response evaluation by fluorine-18 fluorodeoxyglucose positron emission tomography allows in vivo testing of chemosensitivity in gastric cancer: long term results of a prospective study. Clin Cancer Res 2008, 14: 2012–2018. 10.1158/1078-0432.CCR-07-0934PubMedCrossRef

26.

Becker K, Mueller JD, Schulmacher C, Ott K, et al.: Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer 2003, 98: 1521–1530. 10.1002/cncr.11660PubMedCrossRef

27.

Lowy AM, Mansfield PF, Leach SD, Pazdur R, et al.: Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer. Ann Surg 1999, 229: 303–308. 10.1097/00000658-199903000-00001PubMedCentralPubMedCrossRef

28.

Napieralski R, Ott K, Kremer M, Becker K, et al.: Methylation of tumor-related genes in neoadjuvant-treated gastric cancer: Relation to therapy response and clini-copathologic and molecular features. Clin Cancer Res 2007, 13: 5095–5102. 10.1158/1078-0432.CCR-07-0241PubMedCrossRef

29.

Ott K, Vogelsang H, Marton N, Becker K, et al.: The thymidylate synthase tandem repeat promoter polymorphism: a predictor for tumor-related survival in neoadjuvant treated locally advanced gastric cancer. Int J Cancer 2006, 119: 2885–2894. 10.1002/ijc.22235PubMedCrossRef

30.

Ott K, Vogelsang H, Mueller J, Becker K, et al.: Chromosomal instability rather than p53 mutation is associated with response to neoadjuvant cisplatin-based chemotherapy in gastric carcinoma. Clin Cancer Res 2003, 9: 2307–2315.PubMed

31.

Brücher BL, Swisher SG, Königsrainer A, et al.: Response to preoperative therapy in upper gastrointestinal cancers. Ann Surg Oncol 2009, 16: 878–886. 10.1245/s10434-009-0315-xPubMedCrossRef

32.

Beer AJ, Wieder HA, Lordick F, Ott K, et al.: Adeno-carcinomas of esophagogastric junction: multi-detector row CT to evaluate early response to neoadjuvant chemotherapy. Radiology 2006, 239: 472–480. 10.1148/radiol.2391050043PubMedCrossRef

33.

Lordick F, Stein HJ, Peschel C, Siewert JR: Neoadjuvant therapy for oesophagogastric cancer. Br J Surg 2004, 91: 540–551. 10.1002/bjs.4575PubMedCrossRef

34.

Jouve J, Michel P, Mariette C, et al.: Fédération Francophone de Cancérologie Digestive. Outcome of the nonrandomized patients in the FF CD 9102 trial: Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus. J Clin Oncol 2008,26(Suppl):4555.

35.

Chang F, Deere H, Mahadeva U, George S: Histopathologic examination and reporting of esophageal carcinomas following preoperative neoadjuvant therapy: practical guidelines and current issues. Am J Clin Pathol 2008,129(2):252–262. 10.1309/CCR3QN4874YJDJJ7PubMedCrossRef

36.

Ott K, Weber WA, Lordick F, Becker K, et al.: Metabolic imaging predicts response, survival, and recurrence in adeno-carcinomas of the esophago gastric junction. J Clin Oncol 2006, 24: 4692–4698. 10.1200/JCO.2006.06.7801PubMedCrossRef

37.

Weber WA, Ott K, Becker K, et al.: Prediction of response to preoperative chemotherapy in adeno-carcinomas of the esophagogastric junction by metabolic imaging. J Clin Oncol 2001,19(12):3058–3065.PubMed

38.

Wieder HA, Beer AJ, Lordick F, et al.: Comparison of changes in tumor metabolic activity and tumor size during chemotherapy of adeno-carcinomas of the esopha-gogastric junction. J Nucl Med 2005, 46: 2029–2034.PubMed

39.

Lordick F, Ott K, Krause BJ, Weber WA, et al.: PET to assess early metabolic response and to guide treatment of adeno-carcinoma of the oesophagogastric junction: the MUNICON phase II trial. Lancet Oncol 2007, 8: 797–805. 10.1016/S1470-2045(07)70244-9PubMedCrossRef

40.

Ott K, Fink U, Becker K, Stahl A, et al.: Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial. J Clin Oncol 2003, 21: 4604–4610. 10.1200/JCO.2003.06.574PubMedCrossRef

41.

Lordick F, Ruers T, Aust DE, et al.: European Organisation of Research and Treatment of cancer (EORTC) Gastrointestinal Group: Workshop on the role of metabolic imaging in the neoadjuvant treatment of gastrointestinal cancer. Eur J cancer 2008, 44: 1807–1819. 10.1016/j.ejca.2008.06.005PubMedCrossRef

42.

Wang SL, Liao Z, Vaporciyan AA, et al.: Investigation of clinical and dosimetric factors associated with postoperative pulmonary complications in esophageal cancer patients treated with concurrent chemoradiotherapy followed by surgery. Int J Radiat Oncol Biol Phys 2006,64(3):692–699. 10.1016/j.ijrobp.2005.08.002PubMedCrossRef

43.

Urba SG, Orringer MB, Turrisi A, et al.: Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol 2001,19(2):305–313.PubMed

44.

Burmeister BH, Smithers BM, Gebski V, et al.: Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol 2005,6(9):659–668. 10.1016/S1470-2045(05)70288-6PubMedCrossRef

45.

Tepper JE, Krasna M, Niedzwiecki D, et al.: Superiority of trimodality therapy to surgery alone in esophageal cancer: Results of CALGB 9781. J Clin Oncol (Meeting Abstracts) 2006,24(Suppl 18):4012.

46.

Kim S, Lim DH, Lee J, Kang WK, MacDonald JS, Park CH, Park SH, Lee SH, Kim K, Park JO, Kim WS, Jung CW, Park YS, Im YH, Sohn TS, Noh JH, Heo JS, Kim YI, Park CK, Park K: An observational study suggesting clinical benefit for adjuvant postoperative chemoradiation in a population of over 500 cases after gastric resection with D2 nodal dissection for adenocarcinoma of the stomach. Int J Radiat Oncol Biol Phys 2005,63(5):1279–85. 10.1016/j.ijrobp.2005.05.005PubMedCrossRef

47.

Kollmannsberger C, Quietzsch D, Haag C, Lingenfelser T, Schroeder M, Hartmann JT, Baronius W, Hempel V, Clemens M, Kanz L, Bokemeyer C: A phase II study of paclitaxel, weekly, 24-hour continous infusion 5-fluorouracil, folinic acid and cisplatin in patients with advanced gastric cancer. Br J Cancer 2000,83(4):458–62. 10.1054/bjoc.2000.1295PubMedCentralPubMedCrossRef

48.

Stahl M, Budach W, Meyer HJ, Cervantes A, ESMO Guidelines Working Group: Esophageal cancer: clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010,21(Suppl 5):v46–9.PubMedCrossRef

49.

Stahl M, Stuschke M, Lehmann N, Meyer HJ, Walz MK, Seeber S, Klump B, Budach W, Teichmann R, Schmitt M, Schmitt G, Franke C, Wilke H: Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus. J Clin Oncol 2005,23(10):2310–7. Erratum in: J Clin Oncol. 2006 24(3):531 10.1200/JCO.2005.00.034PubMedCrossRef

50.

Bedenne L, Michel P, Bouché O, Milan C, Mariette C, Conroy T, Pezet D, Roullet B, Seitz JF, Herr JP, Paillot B, Arveux P, Bonnetain F, Binquet C: Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol 2007,25(10):1160–8. 10.1200/JCO.2005.04.7118PubMedCrossRef

51.

Mandard AM, Dalibard F, Mandard JC, et al.: Pathologic assessment of tumor regression after preoper-ative chemoradiotherapy of esophageal carcinoma; clinicopathologic correlations. Cancer 1994, 73: 2680–2686. 10.1002/1097-0142(19940601)73:11<2680::AID-CNCR2820731105>3.0.CO;2-CPubMedCrossRef

52.

Baldus SE, Mönig SP, Schröder W, et al.: Regression von Ösophaguskarzinomen nach neoadjuvanter Ra-diochemotherapie. Pathologe 2004, 25: 421–427. 10.1007/s00292-004-0697-2PubMedCrossRef

53.

Schneider PM, Baldus SE, Metzger R, et al.: Histo-morphologic tumor regression and lymph node metastases determine prognosis following neoadjuvant radiochemotherapy for esophageal cancer. Ann Surg 2005, 242: 684–692. 10.1097/01.sla.0000186170.38348.7bPubMedCentralPubMedCrossRef

54.

Thompson SK, Sullivan TR, Davies R, Ruszkiewicz AR: HER-2/neu Gene Amplification in Esophageal Adeno-carcinoma and Its Influence on Survival. Ann Surg On-col 2011, in press.

55.

Van der Gast: Effect of preoperative concurrent chemoradiotherapy on survival of patients with resectable esophageal or esophagogastric junction cancer: Results from a multicenter randomized phase III study. Abstract #4004, ASC0 2010 Annual Meeting, 4–8 June, Chicago

Titel: The role of neoadjuvant and adjuvant treatment for adenocarcinoma of the upper gastrointestinal tract
verfasst von: C Matuschek
E Bölke
M Peiper
WT Knoefel
W Budach
A Erhardt
A Scherer
PA Gerber
BA Buhren
N Gattermann
SE Baldus
E Rusnak
V Shukla
K Orth
Publikationsdatum: 01.12.2011
Verlag: BioMed Central
Erschienen in: European Journal of Medical Research / Ausgabe 6/2011
Elektronische ISSN: 2047-783X
DOI: https://doi.org/10.1186/2047-783X-16-6-265

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

The role of neoadjuvant and adjuvant treatment for adenocarcinoma of the upper gastrointestinal tract

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2011

Management of pelvic lymphoceles after radical prostatectomy: A multicentre community based study

Induction maintenance concept for HAART as initial treatment in HIV infected infants

Comparative examination of subcutaneous tissue reaction to high molecular materials in medical use

The non-invasive 13C-methionine breath test detects hepatic mitochondrial dysfunction as a marker of disease activity in non-alcoholic steatohepatitis

Immunohistochemical localization of notch signaling molecules in ameloblastomas

CD4+ T-lymphopenia in HIV negative tuberculous patients at King Khalid University Hospital in Riyadh, Saudi Arabia