Gastric cancer: epidemiology, prevention, and therapy
|
|
- Owen Wilkins
- 5 years ago
- Views:
Transcription
1 DOI: /hel REVIEW ARTICLE Gastric cancer: epidemiology, prevention, and therapy Marino Venerito 1 Riccardo Vasapolli 1 Theodoros Rokkas 2 Peter Malfertheiner 1 1 Department of Gastroenterology, Hepatology and Infectious Diseases, Ottovon-Guericke University Hospital, Magdeburg, Germany 2 Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece Correspondence Marino Venerito, Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany. m.venerito@med.ovgu.de Abstract Gastric cancer (GC) is still the third leading cause of cancer death in both sexes worldwide. Helicobacter pylori infection is the most important risk factor for GC and, in spite of the consistent trend of a decreasing incidence, in 2015 approximately 4.4 billion individuals more than half the world s population were infected with H. pylori. The birth cohort pattern of decreased H. pylori infection reported in a systematic review contributes to explain the declining GC mortality in Japan. Current trends in estimated annual percentage change of GC incidence foreshadow expected reversals in both falling incidence and male predominance among US non- Hispanic whites. Combining serum pepsinogen 1 and H. pylori serology was shown to be useful for GC risk stratification in a Finnish population. Gastritis staging by operative link on gastritis assessment was confirmed to be reliable in predicting GC risk in a large prospective study. In a randomized trial from South Korea, H. pylori eradication therapy significantly reduced the rates of metachronous GC in patients who received curative endoscopic resection for early GC. A study based on a territory- wide health care database of the Hong Kong Hospital Authority showed that aspirin use is associated with a reduced GC risk. Another study based on the same database showed that proton pump inhibitors increase GC risk, but methodological biases have most likely acted as confounders. Confirmatory data on the role of endoscopic submucosal dissection in patients with early GC have been published. The phase III FLOT4 trial has shown that the FLOT triplet regimen (docetaxel, oxaliplatin, leucovorin, and 5- fluorouracil) improves the outcome of patients with GC and locoregional disease as compared to the ECF triplet (epirubicin, cisplatin, and 5- fluorouracil). In the phase III ATTRACTION- 2 trial, nivolumab was shown to be an effective treatment option with a relative safe profile for heavily pretreated patients with advanced GC. 1 INTRODUCTION Helicobacter pylori infection is the principal risk factor for gastric cancer (GC). During the past year, new important epidemiological data indicated that the prevalence of GC is changing. Serological and histomorphological biomarkers, confirming their value for stratifying the risk of GC, were presented. An additional benefit of aspirin use for GC prevention in patients following H. pylori eradication was demonstrated whereas the continued use of proton pump inhibitors (PPI) following eradication poses an increased risk for GC development. The positive effect of H. pylori eradication therapy for secondary prevention of GC in patients who underwent endoscopic resection of early GC was reported in a randomized placebo controlled trial. Finally, advances have been made in the therapy of GC patients with either locally advanced or non- resectable disease. This review summarizes recent epidemiological aspects and clinical advances in the field of GC prevention and therapy published between April 2017 and March Helicobacter. 2018;23(Suppl. 1):e wileyonlinelibrary.com/journal/hel 2018 John Wiley & Sons Ltd 1 of 6
2 2 of 6 2 GASTRIC CANCER: EPIDEMIOLOGICAL ASPECTS To evaluate changes in the global prevalence of H. pylori infection, Hooi et al 1 performed a systematic review and meta- analysis of 184 full- text articles on the prevalence of H. pylori infection published from 1970 through Data were analyzed based on United Nations geoscheme regions and individual countries. Based on regional prevalence estimates, approximately 4.4 billion individuals more than half the world s population were infected with H. pylori worldwide in 2015, although with large amounts of variation among regions. The highest and lowest pooled prevalence of H. pylori infection were observed in Africa (roughly 70%) and Oceania (roughly 24%), respectively. Switzerland (18.9%) and Nigeria (87.7%) were the countries with the lowest and highest prevalence of H. pylori infection. Two time periods ( and ) were used to analyze the H. pylori prevalence trend over time. H. pylori prevalence after 2000 was lower than before in Europe (from 48.8% to 39.8%), Northern America (42.7% to 26.6%), and Oceania (26.6% to 18.7%). In contrast, the prevalence of H. pylori positivity did not change in Asia (53.6% before 2000 vs 54.3% after 2000), and Latin America and the Caribbean (62.8% before 2000 vs 60.2% after 2000). The changing prevalence of H. pylori infection in the general population over time is considered as the main cause for the declining GC mortality in Japan. In a systematic review with meta- regression analysis, Wang et al 2 reported the prevalence of H. pylori infection among Japanese individuals. The predicted prevalence of H. pylori infection was 60.9% (95% CI ), 64.1% (95% CI ), 34.9% (95% CI ), and 6.6% (95% CI ) among those who were born in the year 1910, 1940, 1970, and 2000, respectively. The birth cohort pattern of H. pylori infection observed fits with the declining GC mortality in Japan. Both H. pylori infection and autoimmune gastritis cause atrophic gastritis, the initial step for non- cardia gastric carcinogenesis. In an epidemiological study, GC incidence trends for U.S. race/ethnic groups in the period was assessed from 45 North American Association of Central Cancer Tumor Registries. 3 There were non- cardia GC in 4.4 billion person- years of observation. Among non- Hispanic whites, the age- standardized rate was 2.2 per person- years, with an estimated annual percentage change (EAPC) of 2.3% (95% CI = 2.0to 2.6). Notwithstanding this overall decline, EAPCs rose 1.3% (95% CI = ) for persons younger than 50 years and fell 2.6% (95% CI = 2.4 to 2.9) for older individuals. These converging trends exhibited a birth cohort effect more pronounced among women than men, with incidence among women born in 1983 twofold (95% CI = 1.1- to 3.6- fold) greater than those born in Age interaction was also statistically significant among Hispanic whites, with slightly increasing vs. decreasing EAPCs for younger and older individuals, respectively. Incidence declined regardless of age for other races. Current trends foreshadow expected reversals in both falling incidence and male predominance among non- Hispanic whites. Possible explanations for the observed trends are the decline in H. pylori prevalence, an increase in smoking for young women and a hypothesized increase in the prevalence of autoimmune gastritis, which is more prevalent among women. These epidemiological observations clearly call for analytical studies to identify potential causal mechanisms and improve prevention strategies. The investigation of non- H. pylori gastric microbiota composition will be of crucial importance in this context. Whether in low prevalence areas for GC patients with gastric intestinal metaplasia (IM), a premalignant condition in gastric carcinogenesis should receive follow- up endoscopy for prevention purposes is still a matter of debate. In a retrospective cohort study, patients with gastric IM diagnosed between 2004 and 2014 (N = 91) received esophagogastroduodenoscopy surveillance every 6-12 months until a diagnosis of GC or completion of the planned 5- year follow- up duration was reached. 4 Possible risk factors for GC were assessed. At baseline, 81 of the 91 patients (89%) had complete IM, whereas the remaining 11% had incomplete IM. None of the patients with complete IM developed GC, whereas five of the 10 patients with incomplete IM (50%) developed high- grade dysplasia (N = 2) or GC (N = 3). Male patients (P = 0.027) and those with incomplete IM (P = 0.001) were at greatest risk of developing dysplasia or early GC. There was also a trend toward an association with smoking (P = 0.08). The authors concluded that further studies are required for determining optimal surveillance intervals to reduce GC incidence and mortality. To evaluate the prevalence and the long- term course of gastric precancerous lesions in patients with gastric MALT- lymphoma (GML), records of patients with GML (N = 179), gastric diffuse large B- cell lymphoma (N = 70), and H. pylori gastritis (N = 152), from a single- center from January 1995 to January 2014 were retrospectively evaluated. 5 At baseline, gastric atrophy was more frequent in the GML group. Furthermore, in patients with GML, gastric atrophy, IM, and gastric dysplasia were more frequent in the GML area than in other part of the stomach. During follow- up, the prevalence of gastric atrophy remained stable whereas IM and dysplasia tended to increase over time. In the multivariate analysis, the development of dysplasia or GC was associated with the presence of IM at baseline and male gender. Thus, after achieving complete remission, GML patients with gastric precancerous lesions may benefit from endoscopic surveillance. 3 GASTRIC CANCER: PREVENTION STRATEGIES/SCREENING FOR PRENEOPLASTIC CONDITIONS Serum pepsinogen 1 (PG1) and H. pylori serology are useful tools for GC risk stratification in Asia. Testing the sera of Finnish male smokers from the Alpha- Tocopherol, Beta- Carotene Cancer Prevention Study, Song et al 6 were also able to show the usefulness of these markers in the Finnish population. PG1 measurements were available for study participants. In a subset (N = 3555) with H. pylori
3 3 of 6 positive serology, both markers jointly defined four groups: the normal PG1 groups A (H. pylori- negative) and B (H. pylori-positive) and the low PG1 groups C (H. pylori- positive) and D (H. pylori- negative). Overall, 329 GCs were diagnosed with an average of 13.9 years after baseline. Low PG1 at baseline was associated with a roughly threefold GC risk (HR 2.68, 95% CI ). Among study participants with both PG1 and H. pylori serology, the GC risk in groups B, C, and D was roughly twofold, fourfold, and sixfold, respectively. Within group B, CagA seropositivity was also associated with an increased GC risk. For groups B and C, repeat measurements of PG1 at 3 years did not add any information in terms of further GC risk stratification. Operative link on gastritis assessment (OLGA) staging estimates the risk for GC in progressive stages (0- IV). In a prospective study performed on a cohort of 1755 consecutive dyspeptic patients with a median follow- up of 55 months, Rugge et al 7 confirmed that OLGA gastritis staging is reliable in predicting the risk for gastric epithelial neoplasia development. After initial endoscopy with mapped gastric biopsies, OLGA staging, and assessment of H. pylori infection, patients with stages II III and IV underwent a second endoscopy with restaging, whereas those with stages 0 and I were followed clinically. At baseline, the majority of patients had stage 0 (77.6%), whereas 14.4%, 5.1%, 2.1%, and 0.85% have stage I, II, III, and IV, respectively. Of the 603 patients with initially detected H. pylori infection, 602 were successfully eradicated. A further 220 patients had a documented history of H. pylori eradication whereas 932 were H. pylori naive- negative. Only patients with stages III- IV developed incident neoplastic lesions (prevalence = 0.4%; low- grade intraepithelial neoplasia = 4; high- grade intraepithelial neoplasia = 1; GC = 2). The risk for epithelial neoplasia was non- existent in patients at stages 0, I, and II, 36.5 per 1000 person- years in patients at stage III (95% CI ) and 63.1 per 1000 person- years in patients at stage IV (95% CI ). In subjects with advanced stages (III- IV), H. pylori eradication did not abolish the risk for neoplastic progression. Patients with early GCs limited to gastric mucosa or submucosa usually have an advanced gastric atrophy and are at high risk for subsequent (metachronous) development of new GC. In a prospective, double- blind, placebo- controlled, randomized trial, 470 patients from South Korea who had undergone endoscopic resection of early GC or high grade adenoma were assigned to receive either H. pylori eradication therapy with antibiotics (amoxicillin 1000 mg and clarithromycin 500 mg twice daily for 7 days) or placebo. 8 Furthermore, the PPI rabeprazole (10 mg twice daily) was given and maintained in both groups for an additional 4 weeks to promote ulcer healing. Two primary outcomes were the incidence of metachronous GC detected on endoscopy performed at the 1- year follow- up or later and improvement from baseline in the grade of gastric atrophy in the gastric corpus lesser curvature at the 3- year follow- up. Overall, 396 patients (194 in the treatment group and 202 in placebo group) were included in the modified intention- to- treat analysis population. During a median follow- up of 5.9 years, lower rates of metachronous GC were observed in the treatment group compared to the placebo group (7.2% vs 13.4%, respectively; HR 0.50; 95% CI ; P = 0.03). Improvement from baseline in the atrophy grade at the gastric corpus lesser curvature was observed in 48.4% and 15.0% of the patients in the treatment and placebo group, respectively (P < 0.001). Thus, in patients undergoing curative endoscopic resection for early GC, H. pylori eradication therapy should be considered mandatory. This study underlines that cure of H. pylori infection should be attempted at all times and rejects the traditional concept of the point of no return. It suggests a strategy of combined colorectal cancer and gastric preneoplasia screening at the age >50 years still in time for an effective GC prevention strategy. 9 The role of aspirin for GC prevention is still uncertain. Based on data from the electronic database of the Clinical Data Analysis and Reporting System of the Hong Kong Hospital Authority, Cheung et al 10 identified subjects who had received a prescription of clarithromycin- based triple therapy for H. pylori between 2003 and The observation period started from prescription dates of H. pylori eradication therapy, and the follow- up was censored at the end of the study (December 2015), death, or GC diagnosis. The frequency (once or more often weekly), dose, and duration of aspirin intake were analyzed. Subjects who failed H. pylori eradication or were diagnosed with GC within 12 months of H. pylori therapy were excluded from the analysis. During a median follow- up of 7.6 years, 169 (0.27%) of patients developed GC. The incidence rate of GC was 3.5 per person- years. Aspirin use was associated with a reduced GC risk (HR 0.30, 95% CI ). The risk of GC significantly decreased with increasing frequency, duration, and dose of aspirin. Overall, the adjusted absolute risk difference between aspirin and non- aspirin use was modest to low (2.52 fewer GCs per person- years). As aspirin is also a major cause of gastrointestinal bleeding, the risk- benefit profile of aspirin use on GC prevention has yet to be defined. The benefit of aspirin use on GC prevention may be highest among patients with advanced preneoplastic conditions (ie, gastric atrophy, IM) whereas in the absence of preneoplastic changes of the gastric mucosa, no further benefit is expected after H. pylori eradication. PPI use is associated with worsening of gastric atrophy, particularly in H. pylori-infected subjects. 11 Using the territory- wide health database of Hong Kong, Cheung et al aimed to determine the association between PPI use and GC among H. pylori-infected subjects who had received H. pylori eradication therapy. 12 Adults who had received an outpatient prescription of clarithromycin- based triple therapy between year 2003 and 2012 were identified. Patients requiring subsequent prescriptions of H. pylori eradication therapies were considered to have failed this regimen and were excluded. Patients diagnosed to have GC within 12 months after H. pylori therapy or gastric ulcer after therapy were also excluded. Finally, prescriptions of PPIs or histamine- 2 receptor antagonists (H2RA) started within 6 months before diagnosis of GC were also exclusion criteria. H2RA was used as a negative control exposure. Among the eligible subjects, 153 (0.24%) developed GC during a median follow- up of 7.6 years. PPI use was associated with an increased GC risk (HR 2.44, 95% CI ), while H2RA was not (HR 0.72, 95% CI ). The risk increased with duration of
4 4 of 6 PPI use (HR 5.04, 95% CI for 1 year; 6.65, 95% CI for 2 years and 8.34, 95% CI , for 3 years). The adjusted absolute risk difference for PPI vs non- PPIs- use was 4.29 excess GC (95% CI ) per person- years. Long- term use of PPIs was still associated with an increased GC risk in subjects even after H. pylori eradication therapy. This study has been criticized for several aspects. First of all, successful eradication therapy was not documented but presumed on the basis of a missing further prescription for H. pylori eradication. Thus, patients developing GC may have had H. pylori eradication failure. 13 Furthermore, the indication for PPI intake after H. pylori eradication was not declared in the study. 4 GASTRIC CANCER: TREATMENT Confirmatory data on the role of endoscopic submucosal dissection (ESD) in patients with early GC were published in the last year. In a Korean prospective multicenter study by Kim et al, patients with early GC who met the absolute and extended criteria and underwent ESD were followed for 5 years. Only selected centers performing a minimum of 20 ESD per year took part to this study. The rate of enbloc resection was 99.1%, whereas complete resections (resection of tumor confined to mucosa with tumor- free margins and without lymphovascular invasion determined by histology) and curative resections (en-bloc resection with tumor- free margins within expanded criteria) were achieved in 81.3% and 86.1%, respectively. The 5- year diseasespecific free survival rate was 90.6%, the 5- year overall survival (OS) rate was 96.6% while the 5- year disease- specific survival rate was 99.8%. Patients developing local recurrence (0.9%) or metachronous lesions (7.8%) were treated by endoscopic or surgical treatment with an excellent long- term survival. Distant metastases were detected in a very low proportion of cases (0.5%) during follow- up. Thus, based on these results, ESD provides a valid curative treatment with an excellent clinical outcome comparable to surgery, at least for Korean patients with early GC presenting themselves in a high volume centre. In a meta- analysis, Hu et al 15 analyzed 13 studies (2106 patients) comparing ESD and surgery for the treatment of early GC. ESD treatment was clearly preferable to surgery in terms of reduced hospitalization time, cost effectiveness, quality of life, and occurrence of adverse events. ESD- treated patients showed a roughly sevenfold higher prevalence of metachronous lesions and recurrence rates compared to the surgically treated patients. This is conceivable, as ESD- treated patients maintained both their stomach and possibly atrophic changes of the gastric mucosa, increasing the risk of metachronous lesions. Also complete resection rates were higher in the surgical group compared to the ESD group (82.7% vs 56.3%, OR = 0.32, 95% CI ). As most of the studies included were retrospective, conducted mostly in one single country (Korea), and lacking relevant information such as survival outcomes and shortterm endoscopic surveillance, data from this analysis should be interpreted cautiously and, at least for the time being, not generalized to the Western population. Due to the lower prevalence of GC, in Western countries, the experience with ESD for patients with early GC is limited to high volume centers. In a monocentric retrospective study, Petruzziello et al 16 reviewed their experience in a series of 70 patients with early GC recruited between November 2007 and May 2015 at the University Hospital Gemelli in Rome, Italy. The majority of ESD procedures (53/70) were performed according to the extended criteria. En-bloc resection was achieved in 68 of 70 (97%) procedures. Histopathologically proven curative R0 resection was reported in 65.6% of cases whereas 22% and 12.4% of patients had a R1 and Rx resection, respectively. Major peri- and postinterventional complications, such as bleeding, occurred in 2.8% of cases. No significant difference in terms of complete resection, complications, and local recurrence rates was observed between patients with standard and extended indications. Although these results are in line with data from series published in the Far East, larger studies are needed to clearly define the role and the outcomes of GC patients treated by ESD in Western countries with low GC incidence. Compared to surgery alone, neoadjuvant and adjuvant strategies improve the outcome of patients with locally advanced GC and adenocarcinoma of the esophagogastric junction (AEG) who receive curative- intent surgery, both in younger and elderly patients. 17 The OE05 multicenter phase III clinical trial conducted in the United Kingdom assessed whether increasing the duration and intensity of neoadjuvant chemotherapy further improved survival compared with the current standard regimen. Patients were recruited between January 2005 and October Overall, 897 patients with surgically resectable AEG Siewert types 1 and 2 were randomized to receive four cycle neoadjuvant chemotherapy with epirubicin, cisplatin, and capecitabine (ECX, N = 451) or the standard 2- cycle neoadjuvant therapy with cisplatin and 5- fluorouracil (CF, N = 446). The median follow- up of the surviving patients was 6.4 years (IQR ), and 93% of the patients had at least 3 years of follow- up assessments. Median OS was 23.4 months (95% CI ) in the CF group and 26.1 months ( ) in the ECX group, with a hazard ratio (HR) of 0.90 (95% CI , P = 0.19), indicating no survival advantages in patients treated with the more intensive ECX- regime. In a multicentric study on adjuvant chemoradiation after resection of GC, Fuchs et al 18 investigated whether the replacement of 5- fluorouracil and leucovorin (5- FU/LV) with the potentially more active ECF regimen (epirubicin, cisplatin, and 5- fluorouracil) leads to an improvement of the patients outcome. In this trial, 546 patients with GC or AEG who underwent surgery were randomized between April 2002 and May 2009 to receive postoperative 5- FU plus LV or ECF, both before and after radiotherapy with 5- FU. No significant differences in the 5- year OS and in the 5- year disease- free survival (DFS) rates were observed between the two study arms (OS 44% in both arms; DFS 39% in the 5- FU/LV arm and 37% in the ECF arm). The addition of docetaxel to a platinum/fluoropyrimidine has been under scrutiny in the German multicenter, open- label, randomized phase III FLOT4 trial presented at the ASCO 2017 meeting. 19 The FLOT regimen consists of docetaxel, oxaliplatin, leucovorin,
5 5 of 6 and 5- fluorouracil. Overall, in the FLOT4 trial, 714 patients with resectable GC or AEG were randomly assigned to receive either thee preoperative and three postoperative cycles of ECF/ECX or four preoperative and four postoperative cycles of FLOT. The wide majority of included patients had an ECOG of 0-1, whereas about 75% were younger than 70 years old. In this population, FLOT significantly increased rates of curative surgery and prolonged median progression- free- survival (18 vs 30 months) and median OS (35 vs 50 months) as compared to ECF/ECX. Toxicity was drug- specific but overall similar between both regimens. Moreover, no differences were observed with respect to serious adverse events or toxic deaths. Accordingly, FLOT can be considered the new standard of care in the perioperative treatment of patients with resectable GC or AEG with a good performance status. In particular, as both FLOT and ECF are platinum/fluoropyrimidine- based triplets and taking into account the data from the OE 05 trial, the advantage of FLOT over ECF/ECX appears to be mainly based on the higher effectiveness of docetaxel compared to epirubicin. 20 Patients with inoperable advanced or metastatic GC undergo palliative chemotherapy usually consisting of a combination of platinum and fluoropyrimidines in the first- line. Second- line treatments generally include a taxane (docetaxel, paclitaxel), or irinotecan, or ramucirumab as a single agent or in combination with paclitaxel. 21 Recent preliminary studies have supported a beneficial effect of therapies with immune checkpoint inhibitors in patients with chemotherapy- refractory advanced disease. In a multicenter randomized, double- blind, placebo- controlled, phase 3 trial, Kang et al 22 assessed the efficacy and the safety of nivolumab, a fully human monoclonal PD- 1 inhibitor antibody, in patients with advanced GC or AEG previously treated with two or more regimens of chemotherapy but naive for any other immunotherapy. Between November 2014 and February 2016, patients from Japan, South Korea, and Taiwan (N = 493) were randomized 2:1 to receive either nivolumab (n = 330) or placebo (n = 163). The median OS was higher in patients treated with nivolumab compared to patients treated with placebo (median OS = 5.26 months, 95% CI and 4.14 months, 95% CI for nivolumab and placebo, respectively, HR 0.63, 95% CI ; P < ). Also the 12- month OS rate was higher in patients treated with nivolumab (12- month OS 26.2%, 95% CI vs. 10.9%, 95% CI for nivolumab and placebo, respectively). Thus, nivolumab might be a new treatment option with a relative safe profile for heavily pretreated patients with advanced GC and AEG. 5 CONCLUSIONS The epidemiology of GC is changing. The birth cohort effect observed for H. pylori infection explains, at least in part, the declining GC mortality in Japan whereas the causal mechanisms responsible for the increasing GC incidence among younger women in the United States need to be unraveled. New evidence supports the usefulness of serological (Pepsinogen I) and histomorphological biomarkers (OLGA staging system) for stratifying GC risk. H. pylori eradication therapy reduces but does not abolish the rate of metachronous GC in patients undergoing endoscopic resection for early GC. Whether regular aspirin use may be an alternative to follow- up endoscopy in these high risk patients has still to be determined. More data has been gained on the role of ESD in patients with early GC. The triplet FLOT can be considered the new standard of care in the perioperative treatment of patients with resectable GC or AEG, whereas nivolumab represents a new treatment option with a relative safe profile for heavily pretreated patients with advanced GC and AEG. DISCLOSURE OF INTERESTS M.V. has served as a speaker, a consultant or an advisory board member for Lilly, Bristol-Myers Squibb, Merck Serono, Bayer vital, Amgen, Nordic Pharma, Shire, Ipsen and Celgene. P.M. has served as a speaker for Abbott Laboratories, Allergan, Alfasigma, Bayer, Biocodex, AstraZeneca, Falk Pharma and Takeda. R.V. and T.R. declare no conflict of interest. REFERENCES 1. Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta- analysis. Gastroenterology. 2017;153: Wang C, Nishiyama T, Kikuchi S, et al. Changing trends in the prevalence of H. pylori infection in Japan ( ): a systematic review and meta- regression analysis of 170,752 individuals. Sci Rep. 2017;7: Anderson WF, Rabkin CS, Turner N, et al. The changing face of noncardia gastric cancer incidence among US non- Hispanic Whites. J Natl Cancer Inst. 2018;110: Pittayanon R, Rerknimitr R, Klaikaew N, et al. The risk of gastric cancer in patients with gastric intestinal metaplasia in 5- year follow-up. Aliment Pharmacol Ther. 2017;46: Rentien A-L, Lévy M, Copie-Bergman C, et al. Long- term course of precancerous lesions arising in patients with gastric MALT lymphoma. Dig Liver Dis. 2018;50: Song M, Camargo MC, Weinstein SJ, et al. Serum pepsinogen 1 and anti- Helicobacter pylori IgG antibodies as predictors of gastric cancer risk in Finnish males. Aliment Pharmacol Ther. 2018;47: Rugge M, Meggio A, Pravadelli C, et al. Gastritis staging in the endoscopic follow- up for the secondary prevention of gastric cancer: a 5- year prospective study of 1755 patients. Gut. 2018;January 6. [Epub ahead of print]. 8. Choi IJ, Kook M-C, Kim Y-I, et al. Helicobacter pylori therapy for the prevention of metachronous gastric cancer. N Engl J Med. 2018;378: Malfertheiner P. Helicobacter pylori treatment for gastric cancer prevention. N Engl J Med. 2018;378: Cheung KS, Chan EW, Wong AYS, et al. Aspirin and risk of gastric cancer after Helicobacter pylori eradication: a territory- wide study. J Natl Cancer Inst. 2018;January 19. [Epub ahead of print]. 11. Malfertheiner P, Kandulski A, Venerito M. Proton- pump inhibitors: understanding the complications and risks. Nat Rev Gastroenterol Hepatol. 2017;14: Cheung KS, Chan EW, Wong AYS, et al. Long- term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population- based study. Gut. 2018;67:
6 6 of Suzuki H, Matsuzaki J. Helicobacter pylori eradication failure may have confounded the recent large- scale health database study that showed proton pump inhibitors increase gastric cancer risk. Gut. 2017;December 15. [Epub ahead of print]. 14. Kim SG, Park CM, Lee NR, et al. Long- term clinical outcomes of endoscopic submucosal dissection in patients with early gastric cancer: a prospective multicenter cohort study. Gut Liv. 2018;12: Hu J, Zhao Y, Ren M, et al. The comparison between endoscopic submucosal dissection and surgery in gastric cancer: a systematic review and meta- analysis. Gastroenterol Res Pract. 2018;2018: Petruzziello L, Campanale M, Spada C, et al. Endoscopic submucosal dissection of gastric superficial neoplastic lesions: a single Western center experience. United European Gastroenterol J. 2018;6: Franck C, Canbay A, Malfertheiner P, Venerito M. Neoadjuvant treatment with cisplatin and S- 1 in elderly patients with oesophagogastric adenocarcinoma and locoregional disease: two case reports and review of the literature. Mol Clin Oncol. 2017;7: Fuchs CS, Niedzwiecki D, Mamon HJ, et al. Adjuvant chemoradiotherapy with epirubicin, cisplatin, and fluorouracil compared with adjuvant chemoradiotherapy with fluorouracil and leucovorin after curative resection of gastric cancer: results from CALGB (Alliance). J Clin Oncol. 2017;35: Al-Batran SE, Homann N, Schmalenberg H, et al. Perioperative chemotherapy with docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX) for resectable gastric or gastroesophageal junction (GEJ) adenocarcinoma (FLOT4- AIO): a multicenter, randomized phase 3 trial. J Clin Oncol. 2017;35(Supplement 15): Bose K, Franck C, Müller MN, et al. Perioperative therapy of oesophagogastric adenocarcinoma: mainstay and future directions. Gastroenterol Res Pract. 2017;2017: Smyth EC, Verheij M, Allum W, et al., on behalf of the ESMO Guidelines Committee. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow- up. Ann Oncol. 2016;27:v38 v Kang Y-K, Boku N, Satoh T, et al. Nivolumab in patients with advanced gastric or gastro- oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO , ATTRACTION- 2): a randomised, double- blind, placebo- controlled, phase 3 trial. Lancet. 2017;390: How to cite this article: Venerito M, Vasapolli R, Rokkas T, Malfertheiner P. Gastric cancer: epidemiology, prevention, and therapy. Helicobacter. 2018;23(Suppl. 1):e org/ /hel.12518
ESMO 2017, Madrid, Spain Dr. Loredana Vecchione Charite Comprehensive Cancer Center, Berlin HIGHLIGHTS ON CANCERS OF THE UPPER GI TRACT
ESMO 2017, Madrid, Spain Dr. Loredana Vecchione Charite Comprehensive Cancer Center, Berlin HIGHLIGHTS ON CANCERS OF THE UPPER GI TRACT DOCETAXEL, OXALIPLATIN AND FLUOROURACIL/LEUCOVORIN (FLOT) FOR RESECTABLE
More informationResectable locally advanced oesophagogastric cancer
Resectable locally advanced oesophagogastric cancer Clinical Case Discussion Florian Lordick University Cancer Center Leipzig University Clinic Leipzig Leipzig, Germany esmo.org DISCLOSURES Honoraria for
More informationChemotherapy for Advanced Gastric Cancer
Chemotherapy for Advanced Gastric Cancer Andrés Cervantes Professor of Medicine DISCLOSURE OF INTEREST Employment: None Consultant or Advisory Role: Merck Serono, Roche, Beigene, Bayer, Servier, Lilly,
More informationThe following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only.
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only. If you have any ques7ons, please contact Imedex via email at:
More informationPerioperative chemotherapy: individualized therapy or same treatment for all? Prof. Dr. med. Salah-Eddin Al-Batran
Perioperative chemotherapy: individualized therapy or same treatment for all? Prof. Dr. med. Salah-Eddin Al-Batran Institute of Clinical Cancer Research Krankenhaus Nordwest UCT - University Cancer Center
More informationNeo- and adjuvant treatment for gastric cancer: The role of chemotherapy
Neo- and adjuvant treatment for gastric cancer: The role of chemotherapy Priv. Doz. Dr. Dr. med. T.O. Götze Institute of Clinical Cancer Research Director: Prof. Dr. S.-E. Al- Batran University Cancer
More informationAdvances in gastric cancer: How to approach localised disease?
Advances in gastric cancer: How to approach localised disease? Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer Surgical resection Pathology assessment and estimation
More informationWhich Treatment Approach is Most Appropriate for Primary Therapy of Gastric Cancer: Neoadjuvant Chemotherapy
Which Treatment Approach is Most Appropriate for Primary Therapy of Gastric Cancer: Neoadjuvant Chemotherapy Joseph Chao, M.D. Assistant Clinical Professor Department of Medical Oncology & Therapeutics
More informationDisclosures. Gastric Intestinal Metaplasia and Early Gastric Cancer: Screening, Surveillance, and Endoscopic Therapy. ASGE Guidelines.
Gastric Intestinal Metaplasia and Early Gastric Cancer: Screening, Surveillance, and Endoscopic Therapy Consultant for: Olympus Medtronic US Endoscopy Disclosures Joo Ha Hwang, MD, PhD Associate Professor
More informationThe following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only.
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only. If you have any ques7ons, please contact Imedex via email at:
More information(Neo-) adjuvant Treatment of Gastric Cancer. - The European View
(Neo-) adjuvant Treatment of Gastric Cancer - The European View Florian Lordick, MD Professor of Oncology Director of the University Cancer Center Leipzig (UCCL) University of Leipzig, Germany My Conflict
More informationPerioperative versus adjuvant management of gastric cancer, update 2013
Perioperative versus adjuvant management of gastric cancer, update 2013 Cornelis J.H. van de Velde, MD, PhD,FRCPS and FACS,Hon. Professor of Surgery President ECCO - the European Cancer Organization Past-President
More informationChemoradiotherapy Versus Chemotherapy for Localized Gastric Cancer: A Mini Review
www.rarediseasesjournal.com Journal of Rare Diseases Research & Treatment Mini-review Open Access Chemoradiotherapy Versus Chemotherapy for Localized Gastric Cancer: A Mini Review Daniel da Motta Girardi
More informationKorean gastric cancer screening program, algorithms and experience.
Korean gastric cancer screening program, algorithms and experience. Jun Haeng Lee, MD. Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea Today s topics Korean cancer screening
More informationVan Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.
Efficacy Results from the ToGA Trial: A Phase III Study of Trastuzumab Added to Standard Chemotherapy in First-Line HER2- Positive Advanced Gastric Cancer Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.
More informationMedicinae Doctoris. One university. Many futures.
Medicinae Doctoris The Before and The After: Can chemotherapy revise the trajectory of gastric and esophageal cancers? Dr. David Dawe MD, FRCPC Medical Oncologist Assistant Professor Disclosures None All
More informationHelicobacter pylori: Diagnosis, treatment and risks of untreated infection
Helicobacter pylori: Diagnosis, treatment and risks of untreated infection Klaus Mönkemüller Department of Gastroenterology, Hepatology und Infectius Diseases Otto-von-Guericke University, Magdeburg bb
More informationCHEMOTHERAPY FOR METASTATIC GASTRIC CANCER
CHEMOTHERAPY FOR METASTATIC GASTRIC CANCER Dr Elizabeth Smyth Royal Marsden, UK ESMO Gastric Cancer Preceptorship Valencia 2017 IMPORTANT CONSIDERATIONS WHEN TREATING ADVANCED GASTRIC CANCER Short OS Pain
More informationTreatment Strategy for Non-curative Resection of Early Gastric Cancer. Jun Haneg Lee. Sungkyunkwan University, Samsung Medical Center, Seoul Korea
Treatment Strategy for Non-curative Resection of Early Gastric Cancer Jun Haneg Lee. Sungkyunkwan University, Samsung Medical Center, Seoul Korea Classic EMR/ESD data analysis style Endoscopic resection
More informationNew developments in pathogenesis, gastric cancer. Matthias Ebert. II. Medizinische Klinik Klinikum rechts der Isar TU München
New developments in pathogenesis, diagnosis, therapy and prevention of gastric cancer Matthias Ebert II. Medizinische Klinik Klinikum rechts der Isar TU München Gastric Cancer Pathogenesis Diagnosis Treatment
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal drainage, after hepatic resection, 159 160 Ablation, radiofrequency, for hepatocellular carcinoma, 160 161 Adenocarcinoma, pancreatic.
More informationESD for EGC with undifferentiated histology
ESD for EGC with undifferentiated histology Jun Haeng Lee, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Biopsy: M/D adenocarcinoma ESD: SRC >>
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Adaptive therapy, for locally advanced gastroesophageal cancers, 447 Adenocarcinoma, emerging novel therapeutic agents for gastroesophageal
More informationPrognostic analysis of gastric mucosal dysplasia after endoscopic resection: A single-center retrospective study
JBUON 2019; 24(2): 679-685 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com ORIGINAL ARTICLE Prognostic analysis of gastric mucosal dysplasia after endoscopic resection:
More informationGetting to the Bottom of Treatment: An Update in the Management of Esophagogastric Cancers
Getting to the Bottom of Treatment: An Update in the Management of Esophagogastric Cancers Disclosures None Cindy L. O Bryant, PharmD, BCOP, FCCP, FHOPA Professor, University of Colorado Skaggs School
More informationThe role of chemoradiotherapy in GE junction and gastric cancer. Karin Haustermans
The role of chemoradiotherapy in GE junction and gastric cancer Karin Haustermans Overview Postoperative chemoradiotherapy Preoperative chemoradiotherapy Palliative radiation Technical aspects Overview
More informationCurrent standards of care in gastric cancer
Current standards of care in gastric cancer Prof Eric Van Cutsem, MD, PhD Digestive Oncology Leuven, Belgium Eric.VanCutsem@uzleuven.be Outline Resectable gastric cancer: the role of neoadjuvant and adjuvant
More informationBarrett s Esophagus: Old Dog, New Tricks
Barrett s Esophagus: Old Dog, New Tricks Stuart Jon Spechler, M.D. Chief, Division of Gastroenterology, VA North Texas Healthcare System; Co-Director, Esophageal Diseases Center, Professor of Medicine,
More informationSystemic treatment in early and advanced gastric cancer
Systemic treatment in early and advanced gastric cancer Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer n Surgical resection n Pathology assessment and estimation
More informationNeo- and adjuvant treatment for gastric cancer: The role of chemotherapy
Anna Dorothea Wagner, PD & MER Department of Oncology University of Lausanne Neo- and adjuvant treatment for gastric cancer: The role of chemotherapy Structure 1. Background and overview 2. Adjuvant chemotherapy:
More informationMy name is Dr. David Ilson, Professor of Medicine at Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center in New York, New York.
Welcome to this CME/CE-certified activity entitled, Integrating the Latest Advances Into Clinical Experience: Data and Expert Insights From the 2016 Meeting on Gastrointestinal Cancers in San Francisco.
More informationRisk Factors for Gastric Tumorigenesis in Underlying Gastric Mucosal Atrophy
Gut and Liver, Vol. 11, No. 5, September 2017, pp. 612-619 ORiginal Article Risk Factors for Gastric Tumorigenesis in Underlying Gastric Mucosal Atrophy Ji Hyun Song 1, Sang Gyun Kim 2, Eun Hyo Jin 1,
More informationIMMUNOTHERAPY FOR GASTROINTESTINAL CANCERS
IMMUNOTHERAPY FOR GASTROINTESTINAL CANCERS Dr Elizabeth Smyth Cambridge University Hospitals NHS Foundation Trust ESMO Gastric Cancer Preceptorship Valencia 2018 DISCLOSURES Honoraria for advisory role
More informationEndoscopic atrophic classification before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia
E311 before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia Authors Institution Masaaki Kodama, Tadayoshi Okimoto, Ryo Ogawa, Kazuhiro Mizukami,
More informationMEETING SUMMARY ECC 2015, SEPTEMBER 25TH 29TH 2015 BY PROF. DR. HANS PRENEN, LEUVEN, BELGIUM. Cancers of the Upper GI Tract
Supported by an Independent Educa1onal Grant from MEETING SUMMARY ECC 2015, SEPTEMBER 25TH 29TH 2015 BY PROF. DR. HANS PRENEN, LEUVEN, BELGIUM Cancers of the Upper GI Tract RE-CLASSIFICATION OF GO CANCER
More informationLong-Term Effects of Helicobacter pylori Eradication on Metachronous Gastric Cancer Development
Gut and Liver, Vol. 12, No. 2, March 218, pp. 133-141 ORiginal Article Long-Term ffects of Helicobacter pylori radication on Metachronous Gastric Cancer Development Seung Jun Han 1, Sang Gyun Kim 1, Joo
More informationCurrent Standard of Care of Gastric Cancer:
Current Standard of Care of Gastric Cancer: Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer Surgical resection Pathology assessment and estimation of risk Treatment
More informationEthnic Distribution of Atrophic Autoimmune Gastritis in the United States
Ethnic Distribution of Atrophic Autoimmune Gastritis in the United States Robert M. Genta, Regan Allen, Massimo Rugge Miraca Life Sciences Research Institute, Miraca Life Sciences, Irving, Texas UTSW University
More informationCurrent Standard of Care of Gastro- Esophageal Cancer
Current Standard of Care of Gastro- Esophageal Cancer Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer Surgical resection Pathology assessment and estimation of risk
More information2015 EUROPEAN CANCER CONGRESS
2015 EUROPEAN CANCER CONGRESS 25-29 September 2015 Vienna, Austria SUMMARY The European Cancer Congress (ECC 2015) combined the 40th European Society for Medical Oncology (ESMO) congress with the 18th
More informationFabienne Warmerdam Zuyderland
GE Fabienne Warmerdam Zuyderland Disclosure ASCO 2017 travelgrant Pfizer CRC ADJUVANT Less is more? More is More! 1 Less is more? Perspectief INT-0035 stadium III (niets vs 5-FU) 6.5-jaars OS 46% vs. 60%
More informationNCCP Chemotherapy Regimen. FLOT Therapy-14 day
INDICATIONS FOR USE: FLOT Therapy-14 Regimen Code 00344a *Reimbursement Indicator INDICATION ICD10 Treatment of locally advanced ( T2) and/or nodal positive (N+) C16 resectable gastric adenocarcinoma Treatment
More informationWhat is the status of Sequential Therapy Versus Standard Triple- Drug Therapy in peptic ulcer disease in eradicating H pylori?
What is the status of Sequential Therapy Versus Standard Triple- Drug Therapy in peptic ulcer disease in eradicating H pylori? Sequential Therapy Versus Standard Triple- Drug Therapy for Helicobacter pylori
More informationGastroesophag Gastroesopha eal Junction Adenocarcinoma: What is the best adjuvant regimen? Michael G. G. H addock Haddock M.D.
Gastroesophageal Junction Adenocarcinoma: What is the best adjuvant regimen? Michael G. Haddock M.D. Mayo Clinic Rochester, MN Locally Advanced GE Junction ACA CT S CT or CT S CT/RT Proposition Chemoradiation
More informationSummary of the study protocol of the FLOT3-Study
Summary of the study protocol of the FLOT3-Study EudraCT no. 2007-005143-17 Protocol Code: S396 Title A Prospective Multicenter Study With 5-FU, Leucovorin, Oxaliplatin and Docetaxel (FLOT) in Patients
More informationBarrett s Esophagus. Abdul Sami Khan, M.D. Gastroenterologist Aurora Healthcare Burlington, Elkhorn, Lake Geneva, WI
Barrett s Esophagus Abdul Sami Khan, M.D. Gastroenterologist Aurora Healthcare Burlington, Elkhorn, Lake Geneva, WI A 58 year-old, obese white man has had heartburn for more than 20 years. He read a magazine
More informationEffect of Helicobacter pylori Eradication on Metachronous Recurrence After Endoscopic Resection of Gastric Neoplasm
60 ORIGINAL CONTRIBUTIONS nature publishing group see related editorial on page x Effect of Helicobacter pylori Eradication on Metachronous Recurrence After Endoscopic Resection of Gastric Neoplasm Suh
More informationMetastatic NSCLC: Expanding Role of Immunotherapy. Evan W. Alley, MD, PhD Abramson Cancer Center at Penn Presbyterian
Metastatic NSCLC: Expanding Role of Immunotherapy Evan W. Alley, MD, PhD Abramson Cancer Center at Penn Presbyterian Disclosures: No relevant disclosures Please note that some of the studies reported in
More informationTrastuzumab for the treatment of HER2 positive advanced gastric cancer Appraisal Consultation Document (ACD)
Trastuzumab for the treatment of HER2 positive advanced gastric cancer Appraisal Consultation Document (ACD) Comments submitted by Dr Patrick Cadigan, RCP registrar on behalf of: NCRI/RCP/RCR/ACP/JCCO
More informationCOMPARISON OF ONCE-A-DAY VERSUS TWICE-A-DAY CLARITHROMYCIN IN TRIPLE THERAPY FOR HELICOBACTER PYLORI ERADICATION
Phil J Gastroenterol 2006; 2: 25-29 COMPARISON OF ONCE-A-DAY VERSUS TWICE-A-DAY CLARITHROMYCIN IN TRIPLE THERAPY FOR HELICOBACTER PYLORI ERADICATION Marianne P Collado, Ma Fatima P Calida, Peter P Sy,
More informationPERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER. Virginie Westeel Chest Disease Department University Hospital Besançon, France
PERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER Virginie Westeel Chest Disease Department University Hospital Besançon, France LEARNING OBJECTIVES 1. To understand the potential of perioperative
More informationTable 2.9. Case control studies of helicobacter pylori infection and oesophageal adenocarcinoma
Characteristics of Characteristics of controls Detection Chow et al (1998) 1993-1995 129 of newly diagnosed oesophageal/gastric cardia (OGC) adenocarcinoma. 224 population controls selected by random digit
More informationOriginal Policy Date
MP 2.04.38 Genetic Testing for Helicobacter pylori Treatment Medical Policy Section Medicine Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013 Return
More informationCurrent status of gastric ESD in Korea. Jun Haeng Lee. Department of Medicine Sungkyunkwanuniversity School of Medicie, Seoul, Korea
Current status of gastric ESD in Korea Jun Haeng Lee. Department of Medicine Sungkyunkwanuniversity School of Medicie, Seoul, Korea Contents Brief history of gastric ESD in Korea ESD/EMR for gastric adenoma
More informationHighlights STOMACH CANCER
UPDATES and NEWS from the Gastrointestinal Cancers Symposium in San Francisco Roma, 10-11 Febbraio 2017 Highlights STOMACH CANCER Lorenzo Fornaro, MD Unit of Medical Oncology 2 Azienda Ospedaliero-Universitaria
More informationDoes Viral Cure Prevent HCC Development
Does Viral Cure Prevent HCC Development Prof. Henry LY Chan Head, Division of Gastroenterology and Hepatology Director, Institute of Digestive Disease Director, Center for Liver Health Assistant Dean,
More informationMaastricht Ⅴ /Florence
2016 21 10 577 Maastricht Ⅴ /Florence 200001 2015 10 8 9 Maastricht V 1 / 2 3 4 / 5 Maastricht Ⅴ Interpretation of Management of Helicobacter pylori Infection the Maastricht Ⅴ / Florence Consensus Report
More informationEndoscopic Submucosal Dissection ESD
Endoscopic Submucosal Dissection ESD Peter Draganov MD Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition University of Florida Gastrointestinal Cancer Lesion that Can be Treated
More informationسرطان المعدة. Gastric Cancer حمود حامد
سرطان المعدة Gastric Cancer ا أ لستاذ الدك تور حمود حامد عميد كلية الطب البشري بجامعة دمشق Epidemiology second leading cause of cancer death and fourth most common cancer worldwide Overall declining Histologic
More informationUpdates and best practices in the management of gastric cancer
Updates and best practices in the management of gastric cancer Olatunji B. Alese, MD Gastrointestinal Oncology, Winship Cancer Institute of Emory University July 28, 2017 1 Incidence 3rd leading cause
More informationPlotting the course: optimizing treatment strategies in patients with advanced adenocarcinoma
Pieter E. Postmus University of Liverpool Liverpool, UK Plotting the course: optimizing treatment strategies in patients with advanced adenocarcinoma Disclosures Advisor Bristol-Myers Squibb AstraZeneca
More informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Al-Batran S-E, Hofheinz RD, Pauligk C, et al.
More informationMedicina Personalizada de Precisión en el Abordaje del Cáncer Gástrico. Dra Desamparados Roda Pérez Hospital Clínico de Valencia Incliva, CIBERONC
Medicina Personalizada de Precisión en el Abordaje del Cáncer Gástrico Dra Desamparados Roda Pérez Hospital Clínico de Valencia Incliva, CIBERONC Gastric cancer Epidemiology Gastric cancer is an important
More informationAdjuvant therapies for large bowel cancer Wasantha Rathnayake, MD
LEADING ARTICLE Adjuvant therapies for large bowel cancer Wasantha Rathnayake, MD Consultant Clinical Oncologist, National Cancer Institute, Maharagama, Sri Lanka. Key words: Large bowel; Cancer; Adjuvant
More informationResearch Article Survival Benefit of Adjuvant Radiation Therapy for Gastric Cancer following Gastrectomy and Extended Lymphadenectomy
International Surgical Oncology Volume 2012, Article ID 307670, 7 pages doi:10.1155/2012/307670 Research Article Survival Benefit of Adjuvant Radiation Therapy for Gastric Cancer following Gastrectomy
More informationReference No: Author(s) 12/05/16. Approval date: committee. June Operational Date: Review:
Reference No: Title: Author(s) Systemic Anti-Cancer Therapy (SACT) Guidelines for Pancreatic Adenocarcinoma Dr Colin Purcell, Consultant Medical Oncologist & on behalf of the GI Oncologists Group, Cancer
More informationHow to treat early gastric cancer? Endoscopy
How to treat early gastric cancer? Endoscopy Presented by Pierre H. Deprez Institution Cliniques universitaires Saint-Luc, Brussels Université catholique de Louvain 2 3 4 5 6 Background Diagnostic or therapeutic
More informationTegafur, gimeracil, and oteracil (known as S1) for first-line palliative treatment of advanced gastric cancer
LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Tegafur, gimeracil, and oteracil (known as S1) for first-line palliative treatment of advanced gastric cancer Tegafur, gimeracil, and oteracil (known as S1) in
More informationUpdated Apr 2017 by Dr. Ko (Medical Oncologist, Abbotsford Cancer Centre)
Metastatic Esophagogastric Cancer Summary Updated Apr 2017 by Dr. Ko (Medical Oncologist, Abbotsford Cancer Centre) Reviewed by Dr. Yoo-Joung Ko (Medical Oncologist, Sunnybrook Odette Cancer Centre, University
More informationUpper Gastrointestinal Cancers in the Elderly. Choo Su Pin Senior Consultant Medical Oncology National Cancer Centre Singapore
Upper Gastrointestinal Cancers in the Elderly Choo Su Pin Senior Consultant Medical Oncology National Cancer Centre Singapore Gastric Cancer --High Global Burden Global Cancer Deaths % of all cancer (2008)
More informationHow to remove BE cancer: EMR or ESD? Expected outcome
How to remove BE cancer: EMR or ESD? Expected outcome Presented by Horst Neuhaus Institution Dpt. of Gastroenterology Evangelisches Krankenhaus Düsseldorf, Germany Indications for endoscopic resection
More informationPresent Status and Perspectives of Colorectal Cancer in Asia: Colorectal Cancer Working Group Report in 30th Asia-Pacific Cancer Conference
Present Status and Perspectives of Colorectal Cancer in Asia: Colorectal Cancer Working Group Report in 30th Asia-Pacific Cancer Conference Jpn J Clin Oncol 2010;40(Supplement 1)i38 i43 doi:10.1093/jjco/hyq125
More informationEffect of Helicobacter pylori Eradication on Long-Term Survival after Distal Gastrectomy for Gastric Cancer
pissn 1598-2998, eissn 25-9256 Cancer Res Treat. 216;48(3):12-129 Original Article http://dx.doi.org/1.4143/crt.215.264 Open Access Effect of Helicobacter pylori Eradication on Long-Term Survival after
More informationNasopharyngeal Cancer/Multimodality Treatment
Nasopharyngeal Cancer/Multimodality Treatment PANAGIOTIS KATSAOUNIS Medical Oncologist IASO GENERAL HOSPITAL Athens, 22/10/2016 1 st Hellenic Multidisciplinary Conference on Head and Neck Cancer INTRODUCTION
More informationChemotherapy and Immunotherapy in Combination Non-Small Cell Lung Cancer (NSCLC)
Chemotherapy and Immunotherapy in Combination Non-Small Cell Lung Cancer (NSCLC) Jeffrey Crawford, MD George Barth Geller Professor for Research in Cancer Co-Program Leader, Solid Tumor Therapeutics Program
More informationAdjuvant treatment for stage III colon cancer
ESMO Preceptorship Programme Rectal cancer Singapur November 2017 Adjuvant treatment for stage III colon cancer Andrés Cervantes Disclosures Consulting and advisory services, speaking or writing engagements,
More informationEarly Helicobacter pylori Eradication Decreases Risk of Gastric Cancer in Patients With Peptic Ulcer Disease
GASTROENTEROLOGY 2009;137:1641 1648 Early Helicobacter pylori Eradication Decreases Risk of Gastric Cancer in Patients With Peptic Ulcer Disease CHUN YING WU,*,, KEN N. KUO, MING SHIANG WU, YI JU CHEN,,#
More informationCa Cardias e Stomaco: le diversita e le terapie
XXII Riunione Nazionale I.T.M.O. Ca Cardias e Stomaco: le diversita e le terapie Maria Di Bartolomeo s.s. Oncologia Medica Gastroenterologica Fondazione IRCCS Istituto Nazionale Tumori Milano OUTLINE History
More informationEGFR inhibitors in NSCLC
Suresh S. Ramalingam, MD Associate Professor Director of Medical Oncology Emory University i Winship Cancer Institute EGFR inhibitors in NSCLC Role in 2nd/3 rd line setting Role in first-line and maintenance
More informationRole of lymph node ratio in selection of adjuvant treatment (chemotherapy vs. chemoradiation) in patients with resected gastric cancer
Original Article Role of lymph node ratio in selection of adjuvant treatment (chemotherapy vs. chemoradiation) in patients with resected gastric cancer Brice Jabo 1, Matthew J. Selleck 2, John W. Morgan
More informationPrinted by Hadi Ranjkeshzadeh on 11/12/2010 4:40:23 PM. For personal use only. Not approved for distribution. Copyright 2010 National Comprehensive
Discussion Categories of Evidence and Consensus Category 1: The recommendation is based on high-level evidence (e.g. randomized controlled trials) and there is uniform consensus. Category 2A: The recommendation
More informationAmerican College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection
American Journal of Gastroenterology ISSN 0002-9270 C 2007 by Am. Coll. of Gastroenterology doi: 10.1111/j.1572-0241.2007.01393.x Published by Blackwell Publishing American College of Gastroenterology
More informationGastric and Colon Cancer. Dr. Andres Wiernik 2017
Gastric and Colon Cancer Dr. Andres Wiernik 2017 GASTRIC CANCER Gastric Cancer Classification Epidemiology General principles of Management 25% GE Junction Gastric Cancer 75% Gastric Cancer Epidemiology
More informationSurgical Management of Advanced Stage Colon Cancer. Nathan Huber, MD 6/11/14
Surgical Management of Advanced Stage Colon Cancer Nathan Huber, MD 6/11/14 Colon Cancer Overview Approximately 50,000 attributable deaths per year Colorectal cancer is the 3 rd most common cause of cancer-related
More informationBarrett s esophagus. Barrett s neoplasia treatment trends
Options for endoscopic treatment of Barrett s esophagus Patrick S. Yachimski, MD MPH Director of Pancreatobiliary Endoscopy Assistant Professor of Medicine Division of Gastroenterology, Hepatology & Nutrition
More informationCan erythropoietin treatment during antiviral drug treatment for hepatitis C be cost effective?
Below Are Selected Good Abstracts from Digestive Disease Week 2006 Meeting Published in Gut. 2006 April; 55(Suppl 2): A1 A119. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1859999/?tool=pmcentrez Can erythropoietin
More informationDisclosures. GI Motility Disorders. Gastrointestinal Motility Disorders & Irritable Bowel Syndrome
Gastrointestinal Motility Disorders & Irritable Bowel Syndrome None Disclosures Jasmine Zia, MD Acting Assistant Professor Division of Gastroenterology, University of Washington 6 th Asian Health Symposium
More informationHelicobacter pylori Eradication in Patients with an Iatrogenic Ulcer after Endoscopic Resection and Peptic Ulcer
ORIGINAL ARTICLE ISSN 1738-3331, https://doi.org/10.7704/kjhugr.2018.18.1.30 The Korean Journal of Helicobacter and Upper Gastrointestinal Research, 2018;18(1):30-37 Helicobacter pylori Eradication in
More informationCarcinoma del retto: Highlights
Carcinoma del retto: Highlights Stefano Cordio Struttura Complessa di Oncologia Medica ARNAS Garibaldi Catania Roma 17 Febbraio 2018 Disclosures Advisory Committee, research funding and speakers bureau
More informationA case of local recurrence and distant metastasis following curative endoscopic submucosal dissection of early gastric cancer
Gastric Cancer (2015) 18:188 192 DOI 10.1007/s10120-014-0341-7 CASE REPORT A case of local recurrence and distant metastasis following curative endoscopic submucosal dissection of early gastric cancer
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Adherence, to bismuth quadruple therapy, 543 546 Adjuvant therapy, probiotics as, 567 569 Age factors, in gastric cancer, 611 612, 616 AID protein,
More informationImmunotherapy for the Treatment of Head and Neck Cancers. Robert F. Taylor, MD Aurora Health Care
Immunotherapy for the Treatment of Head and Neck Cancers Robert F. Taylor, MD Aurora Health Care Disclosures No relevant financial relationships to disclose I will be discussing non-fda approved indications
More informationÐÑÏÓÊÅÊËÇÌÅÍÅÓ ÎÅÍÏÃËÙÓÓÅÓ ÁÍÁÊÏÉÍÙÓÅÉÓ ÅËËÇÍÙÍ ÅÑÅÕÍÇÔÙÍ
ÐÑÏÓÊÅÊËÇÌÅÍÅÓ ÎÅÍÏÃËÙÓÓÅÓ ÁÍÁÊÏÉÍÙÓÅÉÓ ÅËËÇÍÙÍ ÅÑÅÕÍÇÔÙÍ 205 206 ÐÑÏÓÊÅÊËÇÌÅÍÅÓ ÎÅÍÏÃËÙÓÓÅÓ ÁÍÁÊÏÉÍÙÓÅÉÓ ÅËËÇÍÙÍ ÅÑÅÕÍÇÔÙÍ EPITHELIAL CELL TURNOVER IN NON-DYSPLASTIC GASTRIC MUCOSA ADJACENT TO EARLY AND
More informationCetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) in the first-line treatment of metastatic colorectal cancer: a large-scale Phase II study (OPUS)
Cetuximab plus 5-FU/FA/oxaliplatin (FOLFOX-4) in the first-line treatment of metastatic colorectal cancer: a large-scale Phase II study (OPUS) C Bokemeyer, E Staroslawska, A Makhson, I Bondarenko, JT Hartmann,
More informationTrial record 1 of 1 for: GO28341 Previous Study Return to List Next Study
1 von 5 11.12.2013 09:04 A service of the U.S. National Institutes of Health Trial record 1 of 1 for: GO28341 Previous Study Return to List Next Study A Study of GDC-0068 in Combination With Fluoropyrimidine
More informationHigh use of maintenance therapy after triple therapy regimes in Ireland
High use of maintenance therapy after triple therapy regimes in Ireland K Bennett, H O Connor, M Barry, C O Morain, J Feely Department of Pharmacology & Therapeutics Department of Gastroenterology Trinity
More informationNon-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist
Non-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist Vichien Srimuninnimit, MD. Medical Oncology Division Faculty of Medicine, Siriraj Hospital Outline Resectable NSCLC stage
More informationS u p p o r t e d b y a n i n d e p e n d e n t E d u c a t i o n a l G r a n t f r o m B a y e r
EXPERTS KNOWLEDGE SHARE with Prof. Köhne, Dr. Modest and Dr. Vecchione Madrid (Spain) Sunday September 10 th 2017 S u p p o r t e d b y a n i n d e p e n d e n t E d u c a t i o n a l G r a n t f r o m
More informationGASTRIC & PANCREATIC CANCER
GASTRIC & PANCREATIC CANCER ASCO HIGHLIGHTS 2005 Fadi Sami Farhat, MD Head of Hematology Oncology Division Hammoud Hospital University Medical Center Saida Lebanon Tel: +961 3 753 155 E-Mail: drfadi@drfadi.org
More informationImmunotherapy for the Treatment of Head and Neck Cancers. Barbara Burtness, MD Yale University
Immunotherapy for the Treatment of Head and Neck Cancers Barbara Burtness, MD Yale University Disclosures AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim, Bristol-Myers Squibb, Merck & Co., Inc.,
More information