532 research outputs found
Educational needs in gastrointestinal cancer: a consensus position paper from the ESMO Gastrointestinal Cancer Faculty
No full textGastrointestinal (GI) cancers are common in all parts of the world. Effective prevention and early detection of GI cancers are not universally implemented. Therefore, it must be anticipated that the incidence and the mortality of GI cancers will remain high within the next decades. The European Society for Medical Oncology (ESMO) Gastrointestinal Cancer Faculty aims to increase the skills of medical oncologists and other disciplines involved in treating GI malignancies. We aimed to increase the survival chances for patients with GI cancers, augment their quality of life and enable successful return to normal social and professional life during the period of survivorship. ESMO also aims to decrease the economic burden of GI cancer in our societies and national healthcare systems. Therefore, the ESMO Gastrointestinal Cancer Faculty initiated a consensus process based on the Delphi method to identify the most important educational needs of physicians who are concerned with GI malignancies. This paper summarises the process and its results and outlines the mission of ESMO in education.status: Publishe
European Organisation for Research and Treatment of Cancer (EORTC)-gastrointestinal cancer group. Expert opinion on management of gastric and gastro-oesophageal junction adenocarcinoma on behalf of the European Organisation for Research and Treatment of Cancer (EORTC)-gastrointestinal cancer group.
No full textExpert opinion on management of gastric and gastro-oesophageal junction adenocarcinoma on behalf of the European Organisation for Research and Treatment of Cancer (EORTC) - gastrointestinal cancer group
No full textA multidisciplinary approach is mandatory for patients with gastric cancer. Patients should be managed by an experienced team of physicians. The outcome of patients is related to the experience of the multidisciplinary team. Surgery is the cornerstone of the management of patients with resectable gastric cancer. The standard recommendations for resectable gastric adenocarcinoma are free-margin surgery with at least D1 resection combined to removal of a minimum of 15 lymph nodes. It has been shown that the outcome of patients with resectable gastric cancer can be improved by a strategy of perioperative (pre- and postoperative) chemotherapy or by postoperative chemoradiotherapy. The evidence comes from large randomised phase 3 studies. In the treatment of unresectable, locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma, no chemotherapy combination was accepted as the gold standard. Cisplatin/5-FU (CF) and ECF (epirubicin plus CF) regimens have been investigated widely in clinical studies and were until recently presented as the reference regimens. Despite a relative chemosensitivity of gastric cancer, a low rate of complete response was obtained, the response duration was short and patients' outcomes remained poor. Recently, new options have been introduced in the management of advanced gastric cancer. It has been shown that capecitabine is at least as good as 5-FU and that oxaliplatin at least as good as cisplatin in these combinations. It has also been demonstrated that the addition of docetaxel to CF resulted in statistically significant improved efficacy endpoints (including patient's quality of life), but also in an increased toxicity. The DCF regimen (docetaxel, cisplatin and 5-FU) has become, therefore, a new active option in advanced gastric cancer in selected patients in good condition. Further randomised trials are therefore to be designed to further improve chemotherapy by modifying and optimising the chemotherapy regimens, and investigating novel treatment combinations. The addition of biological agents to the optimal chemotherapy regimen may achieve further improvements in efficacy. © 2007 Elsevier Ltd. All rights reserved
The value of response in the neoadjuvant treatment concept - Clinical consequences in hemato-oncology
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[Neoadjuvant therapy for squamous cell carcinoma of the esophagus]
No full textNeoadjuvant treatment for locally advanced squamous cell carcinoma of the esophagus is widely used, despite minimal evidence of its efficacy. With only a minor effect on survival, the benefits of neoadjuvant radiotherapy alone appear to be limited. The same is true for neoadjuvant chemotherapy alone. While no single randomized study has shown a statistically significant result favoring neoadjuvant chemoradiation vs no treatment, the results of three meta-analyses indicate a prognostic benefit. Unfortunately, earlier chemoradiation protocols were associated with considerable side effects and contributed to perioperative morbidity and mortality. In contrast, modern chemoradiation protocols were revealed to be feasible when carried out in experienced institutions. Therefore, neoadjuvant chemoradiation is indicated in locally advanced stages. Patients should be referred to specialized centers for initial treatment planning and resection, and they should be enrolled in clinical studies whenever possible
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