摘要
Gastric cancer with extensive lymph node metastasis(ELM) is usually considered unresectable and is associated with poor outcomes. Cases with clinical enlargement of the para-aortic lymph nodes and/or bulky lymph node enlargement around the celiac artery and its branches are generally dealt with as ELM. A standard treatment for gastric cancer with ELM has yet to be determined. Two phase Ⅱ studies of neoadjuvant chemotherapy followed by surgery showed that neoadjuvant chemotherapy with S-1 plus cisplatin followed by surgical resection with extended lymph node dissection could represent a treatment option for gastric cancer with ELM. However,many clinical questions remain unresolved,including the criteria for diagnosing ELM,optimal regime,number of courses and extent of lymph node dissection.
Gastric cancer with extensive lymph node metastasis(ELM) is usually considered unresectable and is associated with poor outcomes. Cases with clinical enlargement of the para-aortic lymph nodes and/or bulky lymph node enlargement around the celiac artery and its branches are generally dealt with as ELM. A standard treatment for gastric cancer with ELM has yet to be determined. Two phase Ⅱ studies of neoadjuvant chemotherapy followed by surgery showed that neoadjuvant chemotherapy with S-1 plus cisplatin followed by surgical resection with extended lymph node dissection could represent a treatment option for gastric cancer with ELM. However,many clinical questions remain unresolved,including the criteria for diagnosing ELM,optimal regime,number of courses and extent of lymph node dissection.
基金
Supported by A National Cancer Center Research and Development Fund(23-A-16
23-A-19
26-A-4)
a Health and Labour Sciences Research Grant for Clinical Cancer Research(H22-Gan-016) from the Ministry of Health
Labour and Welfare
Japan
