Page 140 - Read Online

Kamiya et al. J Cancer Metastasis Treat 2018;4:35 Journal of Cancer
DOI: 10.20517/2394-4722.2017.76 Metastasis and Treatment

Review Open Access

Current trends in gastric cancer treatment in Europe

Satoshi Kamiya , Ioannis Rouvelas , Mats Lindblad , Magnus Nilsson 1,2
1,2
1
1,2
1 Department of Surgery, Centre of Digestive Diseases, Karolinska University Hospital, Stockholm SE-14186, Sweden.
2 Division of Surgery, Department of Clinical Science, Technology and Intervention (CLINTEC), Karolinska Institutet, Stockhom
SE-14186, Sweden.
Correspondence to: Dr. Magnus Nilsson, Department of Surgery, Centre of Digestive Diseases, Karolinska University Hospital,
Stockholm SE-14186, Sweden. E-mail: magnus.nilsson@ki.se

How to cite this article: Kamiya S, Rouvelas I, Lindblad M, Nilsson M. Current trends in gastric cancer treatment in Europe. J
Cancer Metastasis Treat 2018;4:35. http://dx.doi.org/10.20517/2394-4722.2017.76

Received: 21 Nov 2017 First Decision: 5 Feb 2018 Revised: 13 Feb 2018 Accepted: 6 Jun 2018 Published: 17 Jul 2018
Science Editors: Lucio Miele Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Gastric cancer is one of the major causes of cancer-related deaths, despite the gradual decrease of its incidence in
the West. Minimally invasive procedures, such as endoscopic resection and laparoscopic gastrectomy, have been
successfully introduced in European high-volume centres, in the treatment of early gastric cancer. Regarding advanced,
localized gastric cancer a number of prospective trials have been completed in search of better therapeutic options,
aiming to optimize the efficacy vs. adverse effect ratio. From the results of these prospective randomized trials, the
therapeutic strategy has in the last decades shifted emphasis from adjuvant therapy to neoadjuvant or perioperative
chemotherapy, in curatively intended treatment. Moreover, recent studies have shown promising results in the use of
molecular targeted agents, both in perioperative and palliative settings. The introduction of molecularly targeted therapy
will enable a personalized approach based on each patient’s and tumor’s characteristics, maximizing the benefits
from chemotherapy. The present review article focuses on recent therapeutic trends, as well as future perspectives, of
surgical and oncological gastric cancer treatment in the Western setting, mainly based on landmark clinical trials.

Keywords: Gastric cancer, surgery, neoadjuvant, adjuvant, perioperative, chemotherapy, Western

INTRODUCTION
Recent evidence provided by clinical trials and modern technical developments have strongly facilitated the
employment of a multimodal approach in gastric cancer treatment. Endoscopic resection is now accepted
[1,2]
as a curative option for early gastric neoplastic lesions . At the same time, laparoscopic gastrectomy has
[3,4]
increased in popularity in recent years . For locally advanced gastric cancer, radical gastrectomy with D2
[5]
lymph node dissection has become the standard surgery in most European high volume centers . In addi-
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.jcmtjournal.com