Skip to main content

Advertisement

Springer Nature Link
Log in

Management of gastric adenocarcinoma

  • Review
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Gastric adenocarcinoma is the second most common cause of cancer death worldwide. The prognosis for patients with gastric adenocarcinoma depends on the stage of the disease at the time of diagnosis and treatment. Early gastric cancer, limited to the mucosa and submucosa, is best treated surgically and has a five-year survival rate of 70–95%. Surgical resection remains the primary curative treatment for localised disease. Despite this, the overall survival remains poor. The management of localised gastric adenocarcinoma is complex, and at present there is proven benefit of both preoperative chemotherapy and postoperative chemoradiotherapy. There is no standard regimen of chemotherapy for metastatic disease, although the regimen of ECF (epirubicin, cisplatin and fluorouracil) is the most used regimen, with a median survival of 7–9 months. With new regimens of chemotherapy, such as DCF (docetaxel, cisplatin and fluorouracil) or the combination of irinotecan, cisplatin and bevacizumab, the median survival has increased. Other new agents are under investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jemal A, Tiwari RC, Murray T et al (2004) Cancer statistics, 2004. CA Cancer J Clin 54:8–11

    Article  PubMed  Google Scholar 

  2. Kurtz RC, Sherlock P (1985) The diagnosis of gastric cancer. Semin Oncol 12:11–18

    PubMed  CAS  Google Scholar 

  3. Boring CC, Squires TS, Tong T (1991) Cancer statistics, 1991. CA Cancer J Clin 41:19–24

    Article  PubMed  CAS  Google Scholar 

  4. Salvon-Harman JC, Cady B, Nikulasson S et al (1994) Shifting proportions of gastric adenocarcinomas. Arch Surg 129:381–393

    PubMed  CAS  Google Scholar 

  5. Vizcaino AP, Moreno V, Lambert R, Parkin DM (2002) Time trends incidence of both major histologic types of esophageal carcinomas in selected countries, 1973–1995. Int J Cancer 99:860–868

    Article  PubMed  CAS  Google Scholar 

  6. Sobin LH, Wittekind CH (2002) TNM classification of malignant tumors, 6th Edn. Wiley-Liss, New York

    Google Scholar 

  7. Hermanek P, Henson DE, Hutter RVP, Sobin LH (1993) TNM supplement 1993. A commentary on uniform use. Springer, Berlin

    Google Scholar 

  8. Hundahl SA, Phillips JL, Menck HR (2000) The National Cancer Data Base report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy: fifth edition American Joint Committee on Cancer staging, proximal disease, and the “different disease” hypothesis. Cancer 88:921–932

    Article  PubMed  CAS  Google Scholar 

  9. Parkin D, Pisani P, Ferley J et al (1999) Global cancer statistics. CA Cancer J Clin 49:33–64

    PubMed  CAS  Google Scholar 

  10. Glimelius B, Ekstrom K, Hoffman K et al (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168

    Article  PubMed  CAS  Google Scholar 

  11. Dicken BJ, Bigam DL, Cass C et al (2005) Gastric adenocarcinoma: review and considerations for future directions. Ann Surg 241:27–39

    PubMed  Google Scholar 

  12. Maruyama K, Okabayashi K, Kinoshita T (1987) Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg 11:418–425

    Article  PubMed  CAS  Google Scholar 

  13. Japanese Research Society for Gastric Cancer (1995) Japanese classification of gastric carcinoma. Kanehara, Tokyo

    Google Scholar 

  14. Cuschieri A, Weeden S, Fielding J et al (1999) Patient survival after D1 and D2 resections for gastric cancer: long-term results of the MRC randomized surgical trial. Br J Cancer 79:1522–1530

    Article  PubMed  CAS  Google Scholar 

  15. Bonenkamp JJ, Hermans J, Sasako M, van de Velde CJH (1999) Extended lymph-node dissection for gastric cancer. N Engl J Med 340:908–914

    Article  PubMed  CAS  Google Scholar 

  16. Roig J, Girones J, Garsot E et al (2006) Video-assisted surgery in gastric cancer. Clin Transl Oncol 8:213–217

    PubMed  Google Scholar 

  17. Hermans J, Bonenkamp JJ, Boon MC et al (1993) Adjuvant therapy after curative resection for gastric cancer: meta-analysis of randomized trials. J Clin Oncol 11:1441–1447

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  19. Mari E, Floriani I, Tinazzi A et al (2000) Efficacy of adjuvant chemotherapy after curative resection for gastric cancer: a meta analysis of published randomised trials — a study of the GISCAD (Gruppo Italiano per lo Studio dei Carcinomi dell’Apparato Digerente). Ann Oncol 11:837–843

    Article  PubMed  CAS  Google Scholar 

  20. Zhang ZX, Gu XZ, Yin WB et al (1998) Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adenocarcinoma of gastric cardia (AGC) — report on 370 patients. Int J Radiat Oncol Biol Phys 42:929–934

    Article  PubMed  CAS  Google Scholar 

  21. Takahashi M, Abe M (1986) Intra-operative radiotherapy for carcinoma of the stomach. Eur J Surg Oncol 12:247–250

    PubMed  CAS  Google Scholar 

  22. Moertel CG, Childs DS, O’Fallon JR et al (1984) Combined 5-fluorouracil and radiation therapy as a surgical adjuvant for poor prognosis gastric carcinoma. J Clin Oncol 2:1249–1254

    PubMed  CAS  Google Scholar 

  23. MacDonald JS, Smalley SR, Bendetti J et al (2001) Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 345:725–730

    Article  PubMed  CAS  Google Scholar 

  24. Tormo Ferrero V, Andreu Martinez MJ, Cardenal Macia R, Pomares Arias A (2006) Evaluation of the toxicity of the combined treatment of chemoradiotherapy, according to the scheme of Macdonald, after radical surgery in patients diagnosed of gastric cancer. Clin Transl Oncol 8:611–615

    PubMed  Google Scholar 

  25. Cunningham D, Allum WH, Stenning SP et al (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20

    Article  PubMed  CAS  Google Scholar 

  26. Glimelius B, Ekstrom K, Hoffman K et al (1997) Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 8:163–168

    Article  PubMed  CAS  Google Scholar 

  27. Murad AM, Santiago FF, Petroianu A et al (1993) Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer. Cancer 72:37–41

    Article  PubMed  CAS  Google Scholar 

  28. Pyrhönen S, Kuitunen T, Nyandoto P et al (1995) Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. Br J Cancer 71:58–91

    Google Scholar 

  29. Webb A, Cunningham D, Scarffe JH et al (1997) Randomized trial comparing epirubicin, cisplatin and fluorouracil versus fluorouracil, doxorubicin and methotrexate in advanced esophagogastric cancer. J Clin Oncol 15:261–267

    PubMed  CAS  Google Scholar 

  30. Waters JS, Norman A, Cunningham D et al (1999) Long-term survival after epirubicin, cisplatin and fluorouracil for gastric cancer: results of a randomised trial. Br J Cancer 80:269–272

    Article  PubMed  CAS  Google Scholar 

  31. Ross P, Nicolson M, Cunningham D et al (2002) Prospective randomized trial comparing mitomycin, cisplatin and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin and PVI 5-FU in advanced esophagogastric cancer. J Clin Oncol 20:1996–2004

    Article  PubMed  CAS  Google Scholar 

  32. Cutsem EV, Moiseyenko VM, Tjulandin S et al (2006) Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol 24:4991–4997

    Article  PubMed  CAS  Google Scholar 

  33. Kim DY, Kim JH, Lee SH et al (2003) Phase II study of oxaliplatin, 5-fluorouracil and leucovorin in previously platinum treated patients with advanced gastric cancer. Ann Oncol 14:383–387

    Article  PubMed  CAS  Google Scholar 

  34. Cho EK, Lee WK, Im SA et al (2004) Epirubicin, cisplatin and capecitabine in first line chemotherapy for patients with advanced gastric cancer. J Clin Oncol 22[15 Suppl]:14S

    Google Scholar 

  35. Bokemeyer C, Lampe CS, Clemens MR et al (1997) A phase II trial of paclitaxel and weekly 24 h infusion of 5-fluorouracil/folinic acid in patients with advanced gastric cancer. Anticancer Drugs 8:396–399

    Article  PubMed  CAS  Google Scholar 

  36. Pozzo C, Barone C, Szanto J et al (2004) Irinotecan in combination with 5-fluorouracil and folinic acid or with cisplatin in patients with advanced gastric or esophageal-gastric junction adenocarcinoma: results of a randomized phase II study. Ann Oncol 15:1773–1781

    Article  PubMed  CAS  Google Scholar 

  37. Sumpter KA, Harper-Wynne C, Cunningham D et al (2005) Report of two protocol planned interim analyses in a randomized multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced esophagogastric cancer receiving ECF. Br J Cancer 92:1976–1983

    Article  PubMed  CAS  Google Scholar 

  38. Cunningham D, Rao S, Starling N et al (2006) Randomized multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer: the REAL-2 trial. J Clin Oncol 42:182

    Google Scholar 

  39. Shah MA, Ramanathan RK, Ilson DH et al (2006) Multicenter phase II study of Irinotecan, Cisplatin, and Bevacizumab in patients with metastatic gastric or gastroesophageal junction adenocarcinoma. J Clin Oncol 24:5201–5206

    Article  PubMed  CAS  Google Scholar 

  40. Yu W (2006) A review of adjuvant therapy for resected primary gastric cancer with an update on Taegu’s phase III trial with intraperitoneal chemotherapy. Eur J Surg Oncol 32:655–660

    Article  PubMed  CAS  Google Scholar 

  41. Yu W, Whang I, Chung HY et al (2001) Indications for early postoperative intraperitoneal chemotherapy of advanced gastric cancer: results of a prospective randomized trial, World J Surg 25:985–990

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, C/Dr. Esquerdo, 46, ES-28007, Madrid, Spain

    P. Khosravi Shahi, V. M. Díaz Muñoz de la Espada, P. García Alfonso, S. Encina García, Y. Izarzugaza Perón, J. L. Arranz Cozar, B. Hernández Marín & G. Pérez Manga

Authors
  1. P. Khosravi Shahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. M. Díaz Muñoz de la Espada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. García Alfonso
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Encina García
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. Izarzugaza Perón
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. L. Arranz Cozar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B. Hernández Marín
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G. Pérez Manga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Khosravi Shahi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Khosravi Shahi, P., Díaz Muñoz de la Espada, V.M., García Alfonso, P. et al. Management of gastric adenocarcinoma. Clin Transl Oncol 9, 438–442 (2007). https://doi.org/10.1007/s12094-007-0082-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-007-0082-8

Key words

Search

Navigation