L Ceniceros1, A Chopitea1, F Pardo2, F Rotellar2, L Arbea1, J J Sola3, J C Subtil4, B Sangro5, A Benito6, J L Hernández-Lizoain2, J Rodríguez7. 1. Department of Oncology, Unit for the Research and Treatment of Gastrointestinal Cancer, Clínica Universidad de Navarra, University of Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain. 2. Department of Surgery, Unit for the Research and Treatment of Gastrointestinal Cancer, Clínica Universidad de Navarra, University of Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain. 3. Department of Pathology, Unit for the Research and Treatment of Gastrointestinal Cancer, Clínica Universidad de Navarra, University of Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 4. Department of Endoscopy, Unit for the Research and Treatment of Gastrointestinal Cancer, Clínica Universidad de Navarra, University of Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 5. Department of Liver Unit, Unit for the Research and Treatment of Gastrointestinal Cancer, Clínica Universidad de Navarra, University of Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 6. Department of Radiology, Unit for the Research and Treatment of Gastrointestinal Cancer, Clínica Universidad de Navarra, University of Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 7. Department of Oncology, Unit for the Research and Treatment of Gastrointestinal Cancer, Clínica Universidad de Navarra, University of Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain. jrodriguez@unav.es.
Abstract
BACKGROUND: Synchronous liver metastases (LM) from gastric (GC) or esophagogastric junction (EGJ) adenocarcinoma are a rare events. Several trials have evaluated the role of liver surgery in this setting, but the impact of preoperative therapy remains undetermined. METHODS: Patients with synchronous LM from GC/EGJ adenocarcinoma who achieved disease control after induction chemotherapy (ICT) and were subsequently scheduled to chemoradiotherapy (CRT) to the primary tumor and surgery assessment were retrospectively analyzed. Pathological response, patterns of relapse, progression-free survival (PFS), and overall survival (OS) were calculated. From July 2002 to September 2012, 16 patients fulfilling the inclusion criteria were identified. RESULTS: Primary tumor site was GC (nine patients) or EGJ (seven patients). LM were considered technically unresectable in nine patients. Radiological response to the whole neoadjuvant program was achieved in 13 patients. Eight patients underwent surgical resection of the primary tumor; in five of these LM were resected. A complete pathological response in the primary or in the LM was found in four and three patients, respectively. The most frequent site of relapse/progression was systemic (eight patients). Local and liver-only relapses were observed in two patients each. After a median follow-up of 91 months, the median OS and PFS were 23.0 (95% CI 13.2-32.8) and 17.0 months (95% CI 11.7-22.3). 5-year actuarial PFS is 17.6%. CONCLUSION: Our results suggest that an intensified approach using ICT followed by CRT in synchronous LM from GC/EGJ adenocarcinoma is feasible and may translate into prolonged survival times in selected patients.
BACKGROUND:Synchronous liver metastases (LM) from gastric (GC) or esophagogastric junction (EGJ) adenocarcinoma are a rare events. Several trials have evaluated the role of liver surgery in this setting, but the impact of preoperative therapy remains undetermined. METHODS:Patients with synchronous LM from GC/EGJ adenocarcinoma who achieved disease control after induction chemotherapy (ICT) and were subsequently scheduled to chemoradiotherapy (CRT) to the primary tumor and surgery assessment were retrospectively analyzed. Pathological response, patterns of relapse, progression-free survival (PFS), and overall survival (OS) were calculated. From July 2002 to September 2012, 16 patients fulfilling the inclusion criteria were identified. RESULTS:Primary tumor site was GC (nine patients) or EGJ (seven patients). LM were considered technically unresectable in nine patients. Radiological response to the whole neoadjuvant program was achieved in 13 patients. Eight patients underwent surgical resection of the primary tumor; in five of these LM were resected. A complete pathological response in the primary or in the LM was found in four and three patients, respectively. The most frequent site of relapse/progression was systemic (eight patients). Local and liver-only relapses were observed in two patients each. After a median follow-up of 91 months, the median OS and PFS were 23.0 (95% CI 13.2-32.8) and 17.0 months (95% CI 11.7-22.3). 5-year actuarial PFS is 17.6%. CONCLUSION: Our results suggest that an intensified approach using ICT followed by CRT in synchronous LM from GC/EGJ adenocarcinoma is feasible and may translate into prolonged survival times in selected patients.
Authors: Andreas Andreou; Luca Viganò; Giuseppe Zimmitti; Daniel Seehofer; Martin Dreyer; Andreas Pascher; Marcus Bahra; Wenzel Schoening; Volker Schmitz; Peter C Thuss-Patience; Timm Denecke; Gero Puhl; Jean-Nicolas Vauthey; Peter Neuhaus; Lorenzo Capussotti; Johann Pratschke; Sven-Christian Schmidt Journal: J Gastrointest Surg Date: 2014-08-27 Impact factor: 3.452
Authors: Koji Oba; Xavier Paoletti; Yung-Jue Bang; Harry Bleiberg; Tomasz Burzykowski; Nozomu Fuse; Stefan Michiels; Satoshi Morita; Yasuo Ohashi; Jean-Pierre Pignon; Philippe Rougier; Junichi Sakamoto; Daniel Sargent; Mitsuru Sasako; Kohei Shitara; Akira Tsuburaya; Eric Van Cutsem; Marc Buyse Journal: Eur J Cancer Date: 2013-01-24 Impact factor: 9.162