Gastric Cancer: Evolving Landscape and Emerging Therapies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 1710

Special Issue Editors


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Guest Editor
Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
Interests: gastric cancer; surgery; gastrectomy; clinical trial

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Guest Editor
Visceral Surgery Department, Geneva University Hospital, OH 44041 Geneva, Switzerland
Interests: gastric cancer; esophageal cancer; gastrointestinal surgery

Special Issue Information

Dear Colleagues,

This Special Issue of Cancers will focus on the following aspects:

Epidemiology—changing trends and global disparities: Gastric cancer seems to be a distinct entity in Eastern and Western regions, and in both areas, the rapid decline in Helicobacter pylori infections has changed the incidence of the disease and the spatial distribution of tumors. How has gastric cancer changed across the world? Are we witnessing the future disease landscape for the coming decades?

Pathology—classifications and changing patterns: Gastric cancer has been histologically classified using diverse standards. The recent strides in molecular biology and cancer genomics have enriched our understanding of individual tumor characteristics. Are we going to classify the disease by establishing new standards?

Endoscopy—pioneering diagnostic advances and endoscopic resection: Endoscopic examination is essential for the diagnosis of gastric cancer, and it has undergone significant advancements, enabling precise detection and even on-site histological diagnosis without biopsies. Cutting-edge endoscopic instruments are enabling the aggressive removal of superficial cancers. How far are we proceeding?

Surgery—role in multidisciplinary therapy: Minimally invasive, function-preserving gastrectomy has become widely applicable for early gastric cancer. For locally advanced or even seemingly unresectable cases, a multidisciplinary approach has enhanced resectability and patient survival. What are the present and future roles of surgery within this evolving paradigm?

Systemic therapy—from chemotherapy and immunotherapy to new horizons: As our comprehension of gastric cancer’s biology deepens and immune checkpoint inhibitors rises, systemic therapies are undergoing a revolutionary transformation. Could a future be envisioned where surgery is reserved solely for emergencies?

In summary, this Special Issue will provide deep insight into cutting-edge approaches for gastric cancer.

Prof. Dr. Takeshi Sano
Prof. Dr. Stefan Mönig
Guest Editors

Manuscript Submission Information

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Keywords

  • gastric cancer
  • epidemiology
  • pathology
  • endoscopy
  • surgery
  • systemic therapy

Published Papers (2 papers)

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Research

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14 pages, 1038 KiB  
Article
Posterior and Para-Aortic (D2plus) Lymphadenectomy after Neoadjuvant/Conversion Therapy for Locally Advanced/Oligometastatic Gastric Cancer
by Daniele Marrelli, Stefania Angela Piccioni, Ludovico Carbone, Roberto Petrioli, Maurizio Costantini, Valeria Malagnino, Giulio Bagnacci, Gabriele Rizzoli, Natale Calomino, Riccardo Piagnerelli, Maria Antonietta Mazzei and Franco Roviello
Cancers 2024, 16(7), 1376; https://doi.org/10.3390/cancers16071376 - 31 Mar 2024
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Abstract
Super-extended (D2plus) lymphadenectomy after chemotherapy has been reported in only a few studies. This retrospective study evaluates survival outcomes in a Western cohort of locally advanced or oligometastatic gastric cancer patients who underwent D2plus lymphadenectomy after neoadjuvant chemotherapy. A total of 97 patients [...] Read more.
Super-extended (D2plus) lymphadenectomy after chemotherapy has been reported in only a few studies. This retrospective study evaluates survival outcomes in a Western cohort of locally advanced or oligometastatic gastric cancer patients who underwent D2plus lymphadenectomy after neoadjuvant chemotherapy. A total of 97 patients treated between 2010 and 2022 were included. Of these, 62 had clinical stage II/III disease, and 35 had stage IV disease. Most patients (65%) received preoperative DOC/FLOT chemotherapy. The mean number of lymph nodes harvested was 39. Pathological positive nodes in the posterior/para-aortic stations occurred in 17 (17.5%) patients. Lymphovascular invasion, ypN stage, clinical stage, and perineural invasion were predictive factors for positive posterior/para-aortic nodes. Postoperative complications occurred in 21 patients, whereas severe complications (grade III or more) occurred in 9 cases (9.3%). Mortality rate was 1%. Median overall survival (OS) was 59 months (95% CI: 13–106), with a five-year survival rate of 49 ± 6%; the five-year OS after R0 surgery was 60 ± 7%. In patients with positive posterior/para-aortic nodes, the median OS was 15 months (95% CI: 13–18). D2plus lymphadenectomy after chemotherapy for locally advanced or oligometastatic gastric cancer is feasible and associated with low morbidity/mortality rates. The incidence of pathological metastases in posterior/para-aortic nodes is not negligible even after systemic chemotherapy, with poor long-term survival. Full article
(This article belongs to the Special Issue Gastric Cancer: Evolving Landscape and Emerging Therapies)
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12 pages, 16590 KiB  
Review
Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer
by Mitsuhiro Fujishiro
Cancers 2024, 16(5), 1039; https://doi.org/10.3390/cancers16051039 - 03 Mar 2024
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Abstract
Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-H. pylori IgG antibody values is very promising. After the detection of suspicious lesions of [...] Read more.
Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-H. pylori IgG antibody values is very promising. After the detection of suspicious lesions of EGC, a detailed observation using magnifying endoscopy with band-limited light is necessary, which reveals an irregular microsurface and/or an irregular microvascular pattern with demarcation lines in the case of cancerous lesions. Endocytoscopy enables us to make an in vivo histological diagnosis. In terms of the indications for endoscopic resection, the likelihood of lymph node metastasis and technical difficulties in en bloc resection is considered, and they are divided into absolute, expanded, and relative indications. Endoscopic mucosal resection and endoscopic submucosal dissection are the main treatment modalities nowadays. After endoscopic resection, curability is evaluated histologically as endoscopic curability (eCura) A, B, and C (C-1 and C-2). Recent evidence suggests that the outcomes of endoscopic resection for many EGCs are comparable to those of gastrectomy and that endoscopic resection is the gold standard for node-negative early gastric cancers. Personalized medicine is also being developed to overcome the unmet needs in treatments of EGC, for example the further expansion of indications and newer resection techniques, such as full-thickness resection. Full article
(This article belongs to the Special Issue Gastric Cancer: Evolving Landscape and Emerging Therapies)
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