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

被引：115

作者：

Lutz, Manfred P. ^{[1
]}

Zalcberg, John R. ^{[2
,3
]}

Ducreux, Michel ^{[4
]}

Ajani, Jaffer A. ^{[5
]}

Allum, William ^{[6
]}

Aust, Daniela ^{[7
]}

Bang, Yung-Jue ^{[8
]}

Cascinu, Stefano ^{[9
]}

Hoelscher, Arnulf ^{[10
]}

Jankowski, Janusz ^{[11
]}

Jansen, Edwin P. M. ^{[12
]}

Kisslich, Ralf ^{[13
]}

Lordick, Florian ^{[14
]}

Mariette, Christophe ^{[15
]}

Moehler, Markus ^{[13
]}

Oyama, Tsuneo ^{[16
]}

Roth, Arnaud ^{[17
]}

Rueschoff, Josef ^{[18
]}

Ruhstaller, Thomas ^{[19
]}

Seruca, Raquel ^{[20
]}

Stahl, Michael ^{[21
]}

Sterzing, Florian ^{[22
]}

van Cutsem, Eric ^{[23
]}

van der Gaast, Ate ^{[24
]}

van Lanschot, Jan ^{[25
]}

Ychou, Marc ^{[26
]}

Otto, Florian ^{[27
]}

机构：

[1] CaritasKlinikum St Theresia, Med Klin, D-66113 Saarbrucken, Germany

[2] Univ Melbourne, Dept Med, Melbourne, Vic 3010, Australia

[3] Univ Melbourne, Peter MacCallum Canc Ctr, Melbourne, Vic 3010, Australia

[4] Inst Gustave Roussy, Villejuif, France

[5] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA

[6] Royal Marsden NHS Fdn Trust, London, England

[7] Univ Klinikum Carl Gustav Carus, Inst Pathol, Dresden, Germany

[8] Seoul Natl Univ Hosp, Seoul 110744, South Korea

[9] Azienda Osped Univ Osped Riuniti Umberto I Salesi, Torrette di Ancona, Italy

[10] Univ Cologne, Klin Allgemein Viszeral & Tumorchirurg, D-50931 Cologne, Germany

[11] Barts & London Queen Marys Sch Med & Dent, London, England

[12] Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Amsterdam, Netherlands

[13] Johannes Gutenberg Univ Mainz, Med Klin & Poliklin 1, D-6500 Mainz, Germany

[14] Stadt Klinikum, Braunschweig, Germany

[15] Hop Claude Huriez, Serv Chirurg Digest & Gen, Lille, France

[16] Saku Gen Hosp, Nagano, Japan

[17] HUG, Oncosurg Unit, Geneva, Switzerland

[18] Pathol Nordhessen, Kassel, Germany

[19] Kantonsspital, St Gallen, Switzerland

[20] IPATIMUP, Oporto, Portugal

[21] Kliniken Essen Mitte, Essen, Germany

[22] Heidelberg Univ, Dept Radiat Oncol, Heidelberg, Germany

[23] Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium

[24] Erasmus Univ, Med Ctr, Dept Med Oncol, Daniel den Hoed Canc Ctr, Rotterdam, Netherlands

[25] Erasmus MC, Dept Surg, Rotterdam, Netherlands

[26] Ctr Reg Lutte Canc Val dAurelle, Montpellier, France

[27] Tumor & Brustzentrum ZeTuP, St Gallen, Switzerland

来源：

EUROPEAN JOURNAL OF CANCER | 2012年 / 48卷 / 16期

关键词：

Gastric; Gastroesophageal; Oesophageal cancer; Differential treatment strategies; Subtypes of early gastroesophageal cancer; CLINICAL-PRACTICE GUIDELINES; DIAGNOSIS; MANAGEMENT; ADENOCARCINOMA;

D O I：

10.1016/j.ejca.2012.07.029

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：2941 / 2953

页数：13

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