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Page 2 of 4 Watanabe. J Cancer Metastasis Treat 2018;4:48 I http://dx.doi.org/10.20517/2394-4722.2018.60

University in Sweden, reviewed current trend in gastric cancer treatment in Europe. In Europe, periopera-
tive chemotherapy is the standard care for locally advanced gastric cancer. The regimen for the periop-
erative chemotherapy has shift from the Medical Research Council Adjuvant Gastric Infusional Chemo-
therapy (MAGIC) regimen (Epirubicin, cisplatin, 5-fluorouracil/Epirubicin, Cisplatin, Capecitabine) to the
[6]
fluorouracil, folinic acid, oxaliplatin, taxotere (FLOT) triplet. Harada et al. , University of Texas, M.D.,
Anderson Cancer Center, summarized recent trend in gastric cancer in the USA. In the USA, postoperative
chemoradiation is one of the standard care for locally advanced tumors. When cancer progresses after the
first line therapy, additional biomarkers, including microsatellite instability (MSI) and programmed death-
[7]
ligand 1 (PD-L1) should be tested for the screening of candidates for the checkpoint inhibitors. Eto et al. ,
Cancer Institute Hospital in Japan, reviewed recent publications and guidelines focusing on the progress
in treatment of metastatic gastric cancer in Japan. The incidence of adenocarcinoma in the esophagogastric
junction (EGJ) has been increasing rapidly, especially in Western countries. Although treatment for EGJ
adenocarcinoma has been developed as a type of gastric cancer, recent comprehensive molecular analysis
[8]
revealed differences in molecular mechanisms between EGJ and gastric adenocarcinomas. Toihata et al.
reviewed recent evidence of treatment for advanced EGJ adenocarcinoma.

PC is frequently observed in patients with advanced gastric cancer and is considered to be an incurable
[9]
disease. Hu et al. reviewed the molecular mechanisms of three steps in the development of PC, includ-
ing detachment from the primary tumor, adaptation to the microenvironment of the peritoneal cavity,
and attachment to peritoneal mesothelial cells. Peritoneal lavage cytology (PLC) has been shown to be
an independent predictor of cancer relapse after curative gastrectomy and poor prognosis. Matsuoka and
[11]
[10]
Yashiro reviewed the clinical roles and attributes of PLC in gastric cancer. Sugarbaker summarized
the role and efficacy of neoadjuvant systemic chemotherapy, neoadjuvant intraperitoneal and systemic che-
motherapy, cytoreductive surgery, and perioperative chemotherapy including hyperthermic intraperitoneal
chemotherapy and/or early postoperative intraperitoneal chemotherapy as prevention or treatment for PC.
[12]
Macedo et al. introduced pressurized intraperitoneal aerosol chemotherapy as a treatment option for PC.
[13]
Pergolini et al. performed a systematic review of literature on surgical resection for metastatic gastric
cancer. Survival benefit of surgery in advanced gastric cancer is still unclear. Surgery may play an im-
portant role in highly selected patients. However, further randomized controlled trials are necessary to
clarify the actual impact of surgery in these patients. Recent advances in chemotherapy enabled conversion
[14]
surgery for patients with initially unresectable gastric cancer. Ida and Watanabe reviewed the treat-
ment strategies for stage IV gastric cancer and discussed the potential efficacy of conversion surgery. Pan-
creaticoduodenectomy (PD) is the only possible treatment for achieving R0 resection when a tumor and/
or lymph node metastasis directly invades the pancreatic head or infiltrates the duodenum. However, the
[15]
efficacy and safety of PD for advanced gastric cancer remain unclear. Makuuchi et al. reviewed the lit-
eratures on PD for gastric cancer and their own experience.

Recently, targeting therapies and immune checkpoint blockade have been introduced into gastric cancer
[16]
treatment. Kiyozumi et al. summarized the latest knowledge of focused common cancer targets, signal-
ing pathways, targeting therapies, and immunotherapies for gastric cancer. The late-phase complication
of the large-extent of gastric resection negatively influences patients’ quality of life. Takeuchi and Kitaga-
[17]
wa introduced current status of sentinel lymph node (SN) biopsy and function-preserving gastrectomy
based on the SN biopsy. Robotic assisted surgery is increasingly performed for many types of cancers.
[18]
Tokunaga et al. reviewed the comparative retrospective and prospective studies which have investigated
the difference in short- and long-term outcomes between robotic gastrectomy and laparoscopic gastrectomy.

I would like to express my sincere gratitude to Professor Lucio Miele, Editor-in-Chief, Journal of Cancer
Metastasis and Treatment, for giving me this opportunity. I would like to thank all of the contributing au-