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Highlights of the EORTC St. Gallen International Expert Consensus on the primary therapy of gastric, gastroesophageal and oesophageal cancer - Differential treatment strategies for subtypes of early gastroesophageal cancer

Cited 91 time in Web of Science Cited 102 time in Scopus
Authors
Lutz, Manfred P.; Zalcberg, John R.; Ducreux, Michel; Ajani, Jaffer A.; Allum, William; Aust, Daniela; Bang, Yung-Jue; Cascinu, Stefano; Hoelscher, Arnulf; Jankowski, Janusz; Jansen, Edwin P. M.; Kisslich, Ralf; Lordick, Florian; Mariette, Christophe; Moehler, Markus; Oyama, Tsuneo; Roth, Arnaud; Rueschoff, Josef; Ruhstaller, Thomas; Seruca, Raquel; Stahl, Michael; Sterzing, Florian; van Cutsem, Eric; van der Gaast, Ate; van Lanschot, Jan; Ychou, Marc; Otto, Florian
Issue Date
2012-11
Citation
European Journal of Cancer, Vol.48 No.16, pp.2941-2953
Keywords
GastricGastroesophagealOesophageal cancerDifferential treatment strategiesSubtypes of early gastroesophageal cancer
Abstract
The 1st St. Gallen EORTC Gastrointestinal Cancer Conference 2012 Expert Panel clearly differentiated treatment and staging recommendations for the various gastroesophageal cancers. For locally advanced gastric cancer (>= PT3N+), the preferred treatment modality was pre- and postoperative chemotherapy. The majority of panel members would also treat T2N+ or even T2N0 tumours with a similar approach mainly because pretherapeutic staging was considered highly unreliable. It was agreed that adenocarcinoma of the gastroesophageal junction (AEG) is classified best according to Siewert et al. Preoperative radiochemotherapy (RCT) is the preferred treatment for AEG type I and II tumours. For AEG type III, i.e. tumours which may be considered as gastric cancer, perioperative chemotherapy is the majority approach. For resectable squamous cell cancer of the oesophagus a clear majority recommended radiochemotherapy followed by surgery as optimal approach, irrespective of tumour size. In contrast, definitive RCT was judged appropriate for advanced tumours with extended lymph node involvement (N2) or for cancers of the upper oesophagus. Additional recommendations are presented on the use of endosonography, PET-CT scan and laparoscopy for staging and on the preferred approach to surgery. (c) 2012 Elsevier Ltd. All rights reserved.
ISSN
0959-8049
URI
https://hdl.handle.net/10371/173061
DOI
https://doi.org/10.1016/j.ejca.2012.07.029
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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