Ito S, Ito Y, Misawa K, Shimizu Y, Kinoshita T. Neoadjuvant chemotherapy followed by surgery in gastric cancer patients with extensive lymph node metastasis. World J Clin Oncol 2015; 6(6): 291-294 [PMID: 26677442 DOI: 10.5306/wjco.v6.i6.291]
Corresponding Author of This Article
Seiji Ito, MD, PhD, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya Aichi 464-8681, Japan. seito@aichi-cc.jp
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Seiji Ito, Yuichi Ito, Kazunari Misawa, Yasuhiro Shimizu, Taira Kinoshita, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
Author contributions: Ito S wrote the paper; Ito Y, Misawa K, Shimizu Y and Kinoshita T provided critical revision of the article.
Supported by A National Cancer Center Research and Development Fund (23-A-16, 23-A-19, 26-A-4); and a Health and Labour Sciences Research Grant for Clinical Cancer Research (H22-Gan-016) from the Ministry of Health, Labour and Welfare, Japan.
Conflict-of-interest statement: The authors declare no conflict of interest associated with this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seiji Ito, MD, PhD, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya Aichi 464-8681, Japan. seito@aichi-cc.jp
Telephone: +81-52-7626111 Fax: +81-52-7642963
Received: June 10, 2015 Peer-review started: June 11, 2015 First decision: August 4, 2015 Revised: August 26, 2015 Accepted: September 25, 2015 Article in press: September 28, 2015 Published online: December 10, 2015 Processing time: 181 Days and 21.8 Hours
Abstract
Gastric cancer with extensive lymph node metastasis (ELM) is usually considered unresectable and is associated with poor outcomes. Cases with clinical enlargement of the para-aortic lymph nodes and/or bulky lymph node enlargement around the celiac artery and its branches are generally dealt with as ELM. A standard treatment for gastric cancer with ELM has yet to be determined. Two phase II studies of neoadjuvant chemotherapy followed by surgery showed that neoadjuvant chemotherapy with S-1 plus cisplatin followed by surgical resection with extended lymph node dissection could represent a treatment option for gastric cancer with ELM. However, many clinical questions remain unresolved, including the criteria for diagnosing ELM, optimal regime, number of courses and extent of lymph node dissection.
Core tip: Gastric cancer with extensive lymph node metastasis (ELM) is usually considered unresectable and associated with poor outcomes. Phase II studies of neoadjuvant chemotherapy followed by surgery have shown the efficacy of this multimodal therapy for this pathology, but many clinical questions remain unresolved, including the criteria for diagnosing ELM, optimal regime, number of courses and extent of lymph node dissection.
