The Roles of Surgical Oncologists in the New Era – Minimally Invasive Surgery for Early Gastric Cancer and Adjuvant Surgery for Metastatic Gastric CancerYoshida K. · Yamaguchi K. · Okumura N. · Osada S. · Takahashi T. · Tanaka Y. · Tanabe K. · Suzuki T.
Department of Surgical Oncology, Gifu University, Gifu, Japan
Department of Surgical Oncology
Yanagido, Gifu 501-1194 (Japan)
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In the new era of technical development in surgery, operative devices, molecular targeting and chemotherapeutic agents, surgical oncologists have two main roles in the treatment of gastric cancer. One is to provide patients with minimally invasive surgery, including laparoscopy- or robot-assisted surgery in early gastric cancer patients, and the new concept of surgical intervention toward advanced and metastatic disease. Since recently, laparoscopy-assisted distal gastrectomy has become prevalent in Japan as a surgery which is minimally invasive for the patients and provides them with a good quality of life afterwards. However, the provision of advanced surgical techniques, including lymph node dissection and reconstruction, is more important for patient survival. The second role of surgical oncologists is to evaluate the significant values of the aggressive treatment which we term ‘adjuvant surgery’ for stage IV gastric cancer patients who have successfully responded to initial chemotherapy for curative intent. Stage IV gastric cancer patients are now being informed about the possibility of longer survival with the new chemotherapeutic and surgical strategic approach.
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GLOBOCAN database. http//www-dep.jarc.fr/globocan/globocan.html.
Tajim K: Recent Advances of Cancer in Japan; in Saji S (ed): Recent Advances of Cancer in Asian Countries (commemorative book of the 9th ACOS 2010 in Gifu). Tokyo, Cancer and Chemotherapy, 2010, pp 26–34.
- Yoshida K, Yamaguchi K, Osada S, Kawaguchi Y, Takahashi T, Sakashita F, Tanaka Y: Challenge for a better combination with basic evidence. Int J Clin Oncol 2008;13:212–219.
Aikou T (ed): Japanese Gastric Cancer Association: Japanese Classification of Gastric Carcinoma. Tokyo, Kanehara Shuppan, 2010.
Sano T (ed): Japanese Gastric Cancer Association: Japanese Guideline for Gastric Carcinoma. Tokyo, Kanehara Shuppan, 2010.
- Shiraishi N, Yasuda K, Kitano S: Laparoscopic gastrectomy with lymph node dissection for gastric cancer. Gastric Cancer 2006;9:167–176.
- Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study Group: A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 2007; 245:68–72.
- Uyama I, Sakurai Y, Komori Y, Nakamura Y, Syoji M, Tonomura S, Yoshida I, Masui T, Ochiai M: Laparoscopic gastrectomy with preservation of the vagus nerve accompanied by lymph node dissection for early gastric carcinoma. J Am Coll Surg 2005;200:140–145.
- Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ: Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 2010;11:439–449.
- Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scarffe JH, Lofts FJ, Falk SJ, Iveson TJ, Smith DB, Langley RE, Verma M, Weeden S, Chua YJ, MAGIC Trial Participants: Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11–20.
- Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, Haller DG, Ajani JA, Gunderson LL, Jessup JM, Martenson JA: Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725–730.
- Sasako M, Sano T, Yamamoto S, Kurokawa Y, Nashimoto A, Kurita A, Hiratsuka M, Tsujinaka T, Kinoshita T, Arai K, Yamamura Y, Okajima K, Japan Clinical Oncology Group: D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med 2008;359:453–462.
- Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, Furukawa H, Nakajima T, Ohashi Y, Imamura H, Higashino M, Yamamura Y, Kurita A, Arai K, ACTS-GC Group: Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 2007;357:1810–1820.
- Sano T: Adjuvant and neoadjuvant therapy of gastric cancer: a comparison of three pivotal studies. Curr Oncol Rep 2008;10:191–198.
- Tsuburaya A, Sakamoto J, Morita S, Kodera Y, Kobayashi M, Miyashita Y, Macdonald JS: A randomized phase III trial of post-operative adjuvant oral fluoropyrimidine versus sequential paclitaxel/oral fluoropyrimidine; and UFT versus S1 for T3/T4 gastric carcinoma: the Stomach Cancer Adjuvant Multi-institutional Trial Group (SAMIT) Trial. Jpn J Clin Oncol 2005;35:672–675.
- Park YH, Lee JL, Ryoo BY, Ryu MH, Yang SH, Kim BS, Shin DB, Chang HM, Kim TW, Yuh YJ, Kang YK: Capecitabine in combination with Oxaliplatin (XELOX) as a first-line therapy for advanced gastric cancer. Cancer Chemother Pharmacol 2008;61:623–629.
- Ohtsu A, Shimada Y, Shirao K, Boku N, Hyodo I, Saito H, Yamamichi N, Miyata Y, Ikeda N, Yamamoto S, Fukuda H, Yoshida S: Randomized phase III trial of fluorouracil alone versus fluorouracil plus cisplatin versus uracil and tegafur plus mitomycin in patients with unresectable, advanced gastric cancer: the Japan Clinical Oncology Group study (JCOG 9205). J Clin Oncol 2003;21:54–59.
- Wilson D, Hiller L, Geh I: ECF in gastric cancer. Clin Oncol (R Coll Radiol) 2004;16:381–382.
- Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, Middleton G, Daniel F, Oates J, Norman AR, Upper Gastrointestinal Clinical Studies Group of the National Cancer Research Institute of the UK: Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 2008;358:36–46.
- Ajani JA, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, Rodrigues A, Fodor M, Chao Y, Voznyi E, Marabotti C, Van Cutsem E: Clinical benefit with docetaxel plus fluorouracil and cisplatin compared with cisplatin and fluorouracil in a phase III trial of advanced gastric or gastroesophageal cancer adenocarcinoma: the V-325 Study Group. J Clin Oncol 2007;25:3210–3216.
- Overman MJ, Kazmi SM, Jhamb J, Lin E, Yao JC, Abbruzzese JL, Ho L, Ajani J, Phan A: Weekly docetaxel, cisplatin, and 5-fluorouracil as initial therapy for patients with advanced gastric and esophageal cancer. Cancer 2010;116:1446–1453.
- Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M: S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 2008;9:215–221.
- Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, Lordick F, Ohtsu A, Omuro Y, Satoh T, Aprile G, Kulikov E, Hill J, Lehle M, Rüschoff J, Kang YK, ToGA Trial Investigators: Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 2010;376:687–697.
Suzuki T, Tanabe K, Taomoto J, Yamamoto H, Tokumoto N, Yoshida K, Ohdan H: Preliminary trial of adjuvant surgery for advanced gastric cancer. Oncology Lett 2010;1:743–747.
Satoh S, Okabe S, Teramukai S, Hasegawa N, Ozaki S, Ueda A, Tsuji S, Sakabayashi Y, Sakai Y: Early outcome of phase II study of preoperative chemotherapy (CX) with S-1 plus cisplatin for stage IV gastric cancer: 2010 ASCO Annual Meeting Proceedings (abstract 4124). J Clin Oncol 2010;28:15s.
- Adam R, Aloia T, Lévi F, Wicherts DA, de Haas RJ, Paule B, Bralet M-P, Bouchahda M, Machover D, Ducreux M, Castagne V, Azoulay D, Castaing D: Hepatic resection after rescue cetuximab treatment for colorectal liver metastases previously refractory to conventional systemic therapy. J Clin Oncol 2007;25:4593–4602.
- Poston GP, Adam R, Alberts S, Curley S, Figueras J, Haller D, Kunstlinger F, Mentha G, Nordlinger B, Patt Y, Primrose J, Roh M, Rougier P, Ruers T, Schmoll HJ, Valls C, Nick Vauthey NJ-N, Cornelis M, Kahan JP: OncoSurge: a strategy for improving resectability with curative intent in metastatic colorectal cancer. J Clin Oncol 2005;23:7125–7134.
- Adam R, Wicherts DA, de Haas RJ, Ciacio O, Lévi F, Paule B, Ducreux M, Azoulay D, Bismuth H, Castaing D: Patients with initially unresectable colorectal liver metastases: is there a possibility of cure? J Clin Oncol 2009;27:1829–1835.
- Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH: Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg 2009;249:927–932.
Yoshida K, Yamaguchi K, Sakashita F, Tanaka Y, Sanada Y, Takahashi T, Osada S: Complete laparoscopic gastrectomy preserving autonomic nerves in early gastric cancer (in Japanese). Shoukakigeka 2009;32:1–11.
Yoshida K, Tanabe K, Ukon K, Hihara J, Ohta K, Toge T: Laparoscopy assisted distal gastrectomy (LADG) preserving autonomic nerves; in Kitajima M and Otani Y (eds): Proceedings of the 6th International Gastric Cancer Congress, Yokohama, 2005, pp 389–393.
Ohtani H, Tamamori Y, Noguchi K, Azuma T, Fujimoto S, Oba H, Aoki T, Minami M, Hirakawa K: Meta-analysis of laparoscopy-assisted and open distal gastrectomy for gastric cancer. J Surg Res 2010, E-pub ahead of print.
- Kurokawa Y, Katai H, Fukuda H, Sasako M, Gastric Cancer Surgical Study Group of the Japan Clinical Oncology Group: Phase II study of laparoscopy-assisted distal gastrectomy with nodal dissection for clinical stage I gastric cancer: Japan Clinical Oncology Group study JCOG 0703. Jpn J Clin Oncol 2008;38:501–503.
- Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, Ryu SW, Lee HJ, Song KY: Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report – a phase III multicenter, prospective, randomized trial (KLASS Trial). Ann Surg 2010;251:417–420.
- Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, Wada Y, Ohtoshi M: Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg 2002;195:284–287.
- Fujii M, Kochi M, Takayama T: Recent advances in chemotherapy for advanced gastric cancer in Japan. Surg Today 2010;40:295–300.
- Koizumi W, Tanabe S, Saigenji K, Ohtsu A, Boku N, Nagashima F, Shirao K, Matsumura Y, Gotoh M: Phase I/II study of S-1 combined with cisplatin in patients with advanced gastric cancer. Br J Cancer 2003;89:2207–2212.
Komatsu Y, Yuki S, Tateyama M, Kudo M, Asaka M: Irinotecan plus oral S-1 in patients with advanced gastric cancer-biweekly IRIS regimen. Gan to Kagaku Ryoho 2006;33 (suppl 1):131–134.
- Yoshida K, Hirabayashi N, Takiyama W, Ninomiya M, Takakura N, Sakamoto J, Nishiyama M, Toge T: Phase I study of combination therapy with S-1 and docetaxel (TXT) for advanced or recurrent gastric cancer. Anticancer Res 2004;24:1843–1852.
- Yoshida K, Ninomiya M, Takakura N, Hirabayashi N, Takiyama W, Sa to Y, Todo S, Terashima M, Goto M, Sakamoto J, Nishiyama M: Phase II study of docetaxel and S-1 combination therapy for advanced or recurrent gastric cancer. Clin Cancer Res 2006;12:3402–3407.
- Wada Y, Yoshida K, Suzuki T, Mizuiri H, Konishi K, Ukon K, Tanabe K, Sakata Y, Fukushima M: Synergistic effects of docetaxel and S-1 by modulating the expression of metabolic enzymes of 5-fluorouracil in human gastric cancer cell lines. Int J Cancer 2006;119:783–791.
- Shigematsu H, Yoshida K, Sanada Y, Osada S, Takahashi T, Wada Y, Konishi K, Okada M, Fukushima M: Rapamycin enhances chemotherapy-induced cytotoxicity by inhibiting the expressions of TS and ERK in gastric cancer cells. Int J Cancer 2010;126:2716–2725.
- Imamura H, Iishi H, Tsuburaya A, Hatake K, Imamoto H, Esaki T, et al: Randomized phase III study of irinotecan plus S-1 (IRIS) versus S-1 alone as first-line treatment for advanced gastric cancer (GC0301/TOP-002). Gastric Cancer 2011;14:72–80.
Kim YH, Koizumi W, Lee KH, Kishimoto T, Chung HC, Hara T, Cho JY, Nakajima T, Kim HK, Fujii M: Japan Clinical Cancer Research Organization (JACCRO) and Korean Cancer Study Group (KCSG) inter-group study: randomized phase III study of S-1 alone versus S-1 + docetaxel in the treatment for advanced gastric cancer: the START trial. Gastrointestinal Cancers Symposium General Session (abstract 7). J Clin Oncol 2011;29(suppl 4).
- Tanabe K, Suzuki T, Tokumoto N, Yamamoto H, Yoshida K, Ohdan H: Combination therapy with docetaxel and S-1 as a first-line treatment in patients with advanced or recurrent gastric cancer: a retrospective analysis. World J Surg Oncol 2010;8:40.
Schuhmacher C, Gretschel S, Lordick F, Reichardt P, Hohenberger W, Eisenberger CF, Haag C, Mauer ME, Hasan B, Welch J, Ott K, Hoelscher A, Schneider PM, Bechstein W, Wilke H, Lutz MP, Nordlinger B, Van Cutsem E, Siewert JR, Schlag PM: Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer Randomized Trial 40954. J Clin Oncol 2010, E-pub ahead of print.
- Wada Y, Yoshida K, Hihara J, Jyunya T, Suzuki T, Mizuiri H, Konishi K, Ukon K, Tanabe K: A specific neutrophil elastase inhibitor, sivelestat, suppresses the growth of gastric carcinoma cells by preventing the release of TGF-α. Cancer Sci 2006;97:1037–1043.
- Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D, Giacchetti S, Paule B, Kunstlinger F, Ghémard O, Levi F, Bismuth H: Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy a model to predict long-term survival. Ann Surg 2004;240:644–658.
- Adam R, Wicherts DA, de Haas RJ, Aloia T, Lévi F, Paule B, Guettier C, Kunstlinger F, Delvart V, Azoulay D, Castaing D: Complete pathologic response after preoperative chemotherapy for colorectal liver metastases: myth or reality? J Clin Oncol 2008;26:1635–1641.
- Adam R, de Haas RJ, Wicherts DA, Aloia T, Delvart V, Azoulay D, Bismuth H, Castaing D: Is hepatic resection justified after chemotherapy in patients with colorectal liver metastases and lymph node involvement? J Clin Oncol 2008;26:3672–3680.
- Nuzzo G, Giuliante F, Ardito F, Vellone M, Pozzo C, Cassano A, GiovanniniI, Barone C: Liver resection for primarily unresectable colorectal metastases downsized by chemotherapy. J Gastrointest Surg 2007;11:318–324.
- Saif MW: Secondary hepatic resection as a therapeutic goal in advanced colorectal cancer. World J Gastroenterol 2009;15:3855–3864.
Makuuchi H (ed): The Japan Esophageal Society: Japanese Guideline for Diagnosis and Treatment for Esophageal Cancer.. Tokyo, Kanehara Shuppan, 2007, pp 70–71.
- Nakamura T, Hyashi K, Ota M, Eguchi R, Ide H, Takasaki K, Mitsuhashi N: Salvage esophagectomy after definitive chemotherapy and radiotherapy for advanced esophageal cancer. Am J Surg 2004;188:161–166.
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