Perioperative chemotherapy for locally advanced gastric cancer in Japan: current and future perspectives

The standard treatment for locally advanced gastric cancer differs across the world. In western countries, perioperative chemotherapy or postoperative adjuvant chemoradiotherapy are the preferred treatment options, whereas in Asia, D2 gastrectomy followed by postoperative adjuvant chemotherapy is st...

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Veröffentlicht in:Surgery today (Tokyo, Japan) Japan), 2020-01, Vol.50 (1), p.30-37
Hauptverfasser: Tokunaga, Masanori, Sato, Yuya, Nakagawa, Masatoshi, Aburatani, Tomoki, Matsuyama, Takatoshi, Nakajima, Yasuaki, Kinugasa, Yusuke
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container_end_page 37
container_issue 1
container_start_page 30
container_title Surgery today (Tokyo, Japan)
container_volume 50
creator Tokunaga, Masanori
Sato, Yuya
Nakagawa, Masatoshi
Aburatani, Tomoki
Matsuyama, Takatoshi
Nakajima, Yasuaki
Kinugasa, Yusuke
description The standard treatment for locally advanced gastric cancer differs across the world. In western countries, perioperative chemotherapy or postoperative adjuvant chemoradiotherapy are the preferred treatment options, whereas in Asia, D2 gastrectomy followed by postoperative adjuvant chemotherapy is standard. In Japan, adjuvant chemotherapy with S-1 is the standard treatment for pStage II gastric cancer, whereas adjuvant chemotherapy with a doublet regimen is preferred for pStage III gastric cancer. The efficacy of preoperative neoadjuvant chemotherapy using S-1 plus cisplatin, has been investigated in selected patients with expected poor survival outcomes. To expand the indications for neoadjuvant chemotherapy, a clinical trial investigating the efficacy of preoperative S-1 plus oxaliplatin in patients with cStage III (cT3-4N1-3) gastric cancer (JCOG1509) is ongoing in Japan. The addition of immune checkpoint inhibitors to cytotoxic chemotherapy also seems promising and is being investigated in international randomized clinical trials. Although we have to await the final results of these studies, preoperative neoadjuvant chemotherapy is a promising treatment strategy and likely to become standard treatment for locally advanced gastric cancer in Japan.
doi_str_mv 10.1007/s00595-019-01896-5
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subjects Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy, Adjuvant - trends
Drug Combinations
Gastrectomy - methods
Humans
Japan
Medicine
Medicine & Public Health
Neoadjuvant Therapy - trends
Neoplasm Staging
Oxaliplatin - administration & dosage
Oxonic Acid - administration & dosage
Preoperative Care - trends
Review
Review Article
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Surgery
Surgical Oncology
Tegafur - administration & dosage
title Perioperative chemotherapy for locally advanced gastric cancer in Japan: current and future perspectives
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