Peri-operative therapy for operable gastroesophageal adenocarcinoma: past, present and future

Annals of Oncology : Official Journal of the European Society for Medical Oncology
V AggelisElizabeth C Smyth

Abstract

Surgery represents the only chance of cure for patients with gastroesophageal adenocarcinoma; however, surgery alone does not cure most patients. Over the past decade, several multimodality adjunctive treatments have improved survival for patients with operable gastroesophageal adenocarcinoma who are undergoing surgical resection; these include peri-operative chemotherapy, neoadjuvant chemoradiotherapy, adjuvant chemotherapy and adjuvant chemoradiotherapy. More recently, the results of several large randomised trials are leading to a shift in the peri-operative treatment of gastroesophageal cancer, away from anthracycline-based and towards taxane-based chemotherapy regimens. Emerging data support an increased focus on patients who are at high risk for poor operative outcomes such as R1 resection, and on patients who are at high risk for relapse following surgery such as those with lymph node metastases (N1+). Future developments may include use of fluorodeoxyglucose-positron emission tomography to inform a switch to non-cross resistant chemotherapy pre-operatively and substitution of alternative treatments for chemotherapy in high risk post-operative node positive patients. Conversely, in molecularly selected subgroups such as ...Continue Reading

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Citations

May 3, 2021·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Harry H YoonSteven R Alberts

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