Highlights of the EORTC st. gallen international expert consensus on the primary therapy of gastric, gastroesophageal and oesophageal cancer - Differential treatment strategies for subtypes of early gastroesophageal cancer

Manfred P. Lutz, John R. Zalcberg, Michel Ducreux, Jaffer A. Ajani, William Allum, Daniela Aust, Yung Jue Bang, Stefano Cascinu, Arnulf Hölscher, Janusz Jankowski, Edwin P.M. Jansen, Ralf Kisslich, Florian Lordick, Christophe Mariette, Markus Moehler, Tsuneo Oyama, Arnaud Roth, Josef Rueschoff, Thomas Ruhstaller, Raquel SerucaMichael Stahl, Florian Sterzing, Eric Van Cutsem, Ate Van Der Gaast, Jan Van Lanschot, Marc Ychou, Florian Otto

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108 Citations (Scopus)

Abstract

The 1st St. Gallen EORTC Gastrointestinal Cancer Conference 2012 Expert Panel clearly differentiated treatment and staging recommendations for the various gastroesophageal cancers. For locally advanced gastric cancer (≥T3N+), the preferred treatment modality was pre- and postoperative chemotherapy. The majority of panel members would also treat T2N+ or even T2N0 tumours with a similar approach mainly because pretherapeutic staging was considered highly unreliable. It was agreed that adenocarcinoma of the gastroesophageal junction (AEG) is classified best according to Siewert et al. Preoperative radiochemotherapy (RCT) is the preferred treatment for AEG type I and II tumours. For AEG type III, i.e. tumours which may be considered as gastric cancer, perioperative chemotherapy is the majority approach. For resectable squamous cell cancer of the oesophagus a clear majority recommended radiochemotherapy followed by surgery as optimal approach, irrespective of tumour size. In contrast, definitive RCT was judged appropriate for advanced tumours with extended lymph node involvement (N2) or for cancers of the upper oesophagus. Additional recommendations are presented on the use of endosonography, PET-CT scan and laparoscopy for staging and on the preferred approach to surgery.

Original languageEnglish
Pages (from-to)2941-2953
Number of pages13
JournalEuropean Journal of Cancer
Volume48
Issue number16
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

Keywords

  • Differential treatment strategies
  • Gastric
  • Gastroesophageal
  • Oesophageal cancer
  • Subtypes of early gastroesophageal cancer

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