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KMID : 1188520140100010001
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Korean Journal of Clinical Oncology
2014 Volume.10 No. 1 p.1 ~ p.5
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Neoadjuvant chemotherapy in localized resectable stomach cancer
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Ryu Min-Hee
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Abstract
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In localized resectable stage II or III gastric cancer, D2 dissection has been accepted as the standard surgical method worldwide. The Adjuvant Chemotherapy Trial of TS-1 for Gastric Cancer and Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer phase III trials have demonstrated that systemic adjuvant chemotherapy can significantly improve recurrence-free survival (RFS) and overall survival (OS) after D2 dissection with absolute survival benefit of 10% to 15% compared with surgery alone. Addition of radiation or intensification of adjuvant chemotherapy has been tried in localized resectable gastric cancer for further improvements of RFS and OS as well. However, addition of radiation after D2 dissection was proven to play no or only a minimal role at its best in reduction of loco-regional recurrences as well as distant metastases. The results of recent large-scale adjuvant trials suggest that more intensified adjuvant treatment including multiple chemotherapeutic agents would not likely induce a better result. For this reason, addition of neoadjuvant chemotherapy to current standard of care may be the only plausible strategy to improve long-term outcomes in localized resectable gastric cancer, and clinical trials of neoadjuvant chemotherapy are now ongoing in gastric cancer.
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KEYWORD
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Neoadjuvant therapy, Gastric cancer, Cancer chemotherapy agents
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