• Title/Summary/Keyword: Digestive cancer

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Current Status of Robotic-assisted Surgery in Gastric Cancer

  • Eli Kakiashvili
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.99-106
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    • 2016
  • Minimally invasive surgery for gastric cancer has increased in popularity during the last two decades mainly in the Asia for patients with early-stage cancer. Nevertheless, the development of laparoscopic surgery for gastric cancers in the Western world has been slow because of the advanced stage at diagnosis for which LG is not yet considered an acceptable alternative to standard open surgery. RAG has been reported as a safe alternative to conventional surgery for treating of early gastric carcinoma. We assess the current status of robotic surgery in the treatment of gastric cancer focusing on the technical details, postoperative outcome, oncological considerations and future perspectives. In gastrectomy the biggest advantage of the robotic approach is the ease and reproducibility of lymphadenectomy. Reports also show that even the intra corporeal digestive restoration is facilitated by use of the robotic approach, particularly following TG. Additionally, the accuracy of robotic dissection is confirmed by decreased blood loss in comparison to conventional laparoscopy. The learning curve and technical reproducibility also appear to be shorter with robotic surgery and, consequently, robotics can help to standardize and diffuse minimally invasive surgery in the treatment of gastric cancer. While published reports have shown no significant differences in surgical morbidity, mortality, or oncological adequacy between robot-assisted and conventional gastrectomy. There are some advantages in terms of postoperative recovery of patients after robotic surgery. More studies are needed to assess the true indications and oncological effectiveness of robotic use in the treatment of gastric carcinoma.

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Novel Biomarkers for Prediction of Response to Preoperative Systemic Therapies in Gastric Cancer

  • Cavaliere, Alessandro;Merz, Valeria;Casalino, Simona;Zecchetto, Camilla;Simionato, Francesca;Salt, Hayley Louise;Contarelli, Serena;Santoro, Raffaela;Melisi, Davide
    • Journal of Gastric Cancer
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    • v.19 no.4
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    • pp.375-392
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    • 2019
  • Preoperative chemo- and radiotherapeutic strategies followed by surgery are currently a standard approach for treating locally advanced gastric and esophagogastric junction cancer in Western countries. However, in a large number of cases, the tumor is extremely resistant to these treatments and the patients are exposed to unnecessary toxicity and delayed surgical therapy. The current clinical trials evaluating the combination of preoperative systemic therapies with modern targeted and immunotherapeutic agents represent a unique opportunity for identifying predictive biomarkers of response to select patients that would benefit the most from these treatments. However, it is of utmost importance that these potential biomarkers are corroborated by extensive preclinical and translational research. The aim of this review article is to present the most promising biomarkers of response to classic chemotherapeutic, anti-HER2, antiangiogenic, and immunotherapeutic agents that can be potentially useful for personalized preoperative systemic therapies in gastric cancer patients.

Current and New Molecularly Targeted Agents for Metastatic Gastric Cancer

  • Sung Chul Park
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.11-16
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    • 2015
  • The discovery of HER2, a biomarker in advanced gastric cancer, and successful clinical trial using trastuzumab that targets this biomarker signaled a revolutionary turning point in treatment of metastatic gastric cancer. Many studies about targeted agents for gastric cancer have been attempted. Among them, ramicirumab, a monoclonal antibody that targets vascular endothelial growth factor receptor-2 (VEGFR-2), and apatinib, a tyrosine kinase inhibitor (TKI) that targets VEGFR2, have shown to improve the survival rates in advanced gastric cancer patients, for whom previous therapies had failed; hence, they are expected to be accepted as one of the standard therapies for advanced gastric cancer.

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Practical Management of Cancer Pain (암성 통증의 관리)

  • Jin Seok Jang
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.56-63
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    • 2014
  • Cancer pain is one of the most serious undesirable and unsolved complications for the cancer patients. Despite significant improvements in the management of cancer pain through past decades, it is still perceived as insufficient. Effective management of pain starts on a comprehensive assessment to identify the origin and characteristics of the pain. Then, appropriate multidisciplinary medical and surgical interventions could provide optimal treatments. With intensive attentions, complete or partial pain relief with tolerable side effects of the medication will be obtained and it will improve the quality of life of cancer patients.

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Adjuvant Therapy of Pancreatic Cancer

  • Paik, Woo Hyun
    • Journal of Digestive Cancer Research
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    • v.7 no.1
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    • pp.5-7
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    • 2019
  • Pancreatic cancer is a lethal disease since curative resection is available in only 20% of patients at the initial diagnosis. Even after radical resection of the cancer, most patients experience recurrence. Therefore, many clinical trials have been attempted to prevent recurrence of pancreatic cancer. The key clinical studies about adjuvant therapy of pancreatic cancer and currently available regimens in Korea will be reviewed concisely according to the chemotherapy, radiation therapy, or both.

Epidemiology of early esophageal adenocarcinoma

  • Thuy-Van P. Hang;Zachary Spiritos;Anthony M. Gamboa;Zhengjia Chen;Seth Force;Vaishali Patel;Saurabh Chawla;Steven Keilin;Nabil F. Saba;Bassel El-Rayes;Qiang Cai;Field F. Willingham
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.372-380
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    • 2022
  • Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%-5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.

Pro Variant of TP53 Arg72Pro Contributes to Gastric Cancer Risk in Asians: Evidence from a Meta-analysis

  • Su, Xiu-Li;Jin, Jian-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.915-921
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    • 2012
  • Background: Previous studies investigating the association between TP53 Arg72Pro polymorphism and gastric cancer (GC) risk in Asian population have reported controversial results. Thus, a meta-analysis was performed. Methods: A comprehensive literature search was conducted and 17 case-control studies were finally included, involving a total of 5,990 GC cases and 6,812 controls. Subgroup analyses were performed by the sample size. Results: Meta-analysis of all 17 studies showed variant genotypes of TP53 Arg72Pro to be associated with an elevated GC risk in three genetic comparison models ($OR_{Pro\;vs.\;Arg}$=1.13, 95%CI 1.03-1.25, $P_{OR}$=0.01; $OR_{Homozygote\;comparison\;model}$=1.33, 95%CI 1.07-1.64, $P_{OR}$=0.009; $OR_{Dominant\;genetic\;model}$=1.13, 95%CI 1.05-1.22, $P_{OR}$=0.002). Besides, a more obvious association was observed after the heterogeneity was decreased (all P values less than 0.001). This association was further identified by both subgroup and sensitivity analyses. Conclusions: This meta-analysis suggests the Pro variant of TP53 Arg72Pro contributes to gastric cancer risk in Asians.