Dabout Victoire, de la Fouchardière Christelle, Voron Thibault, André Thierry, Huguet Florence, Cohen Romain
Hôpital Saint-Antoine, AP-HP, Sorbonne université, service d'oncologie médicale, Inserm UMRS 938, Équipe Instabilité des Microsatellites et Cancer, Équipe Labellisée par la Ligue Nationale Contre le Cancer et SIRIC CURAMUS, Centre de recherche Saint Antoine, Paris, France.
Centre Léon Bérard, Département d'oncologie médicale, 28, rue Laennec, Lyon, France.
Bull Cancer. 2023 May;110(5):521-532. doi: 10.1016/j.bulcan.2022.05.014. Epub 2022 Aug 11.
Gastric cancer is the 6th most common cancer in the world. Gastric adenocarcinomas can be divided into two groups: gastroesophageal junction adenocarcinomas and distal gastric adenocarcinomas, with different risk factors and potentially different therapeutic strategies. Therapeutic strategy for esogastric adenocarcinoma is multimodal. Gastric adenocarcinomas are managed with surgery and peri-operative chemotherapy. Gastroesophageal junction adenocarcinomas can either be treated surgically after neoadjuvant chemoradiotherapy or in the same way than gastric adenocarcinomas. There is currently no evidence of superiority of either treatment strategy. Recently, nivolumab has been validated as an adjuvant therapy for patients with esophageal cancer who received preoperative chemoradiotherapy and had residual tumor on the surgical specimen. In the absence of preoperative treatment, adjuvant chemoradiotherapy or chemotherapy should be discussed on a patient-by-patient basis. Currently, there is not indication for targeted therapies, nor for adapting postoperative treatment according to the response to preoperative treatment. The only validated indication for immunotherapy is as adjuvant treatment of esophageal cancer, but many studies are ongoing and may change practices in the future. The objective of this review is to synthesize the literature concerning the management of localized esogastric adenocarcinoma.
胃癌是全球第六大常见癌症。胃腺癌可分为两组:胃食管交界腺癌和远端胃腺癌,它们具有不同的危险因素和潜在不同的治疗策略。胃食管腺癌的治疗策略是多模式的。胃腺癌通过手术和围手术期化疗进行管理。胃食管交界腺癌既可以在新辅助放化疗后进行手术治疗,也可以采用与胃腺癌相同的方式治疗。目前没有证据表明哪种治疗策略更具优势。最近,纳武单抗已被证实可作为接受术前放化疗且手术标本有残留肿瘤的食管癌患者的辅助治疗。在没有术前治疗的情况下,应根据患者个体情况讨论辅助放化疗或化疗。目前,没有靶向治疗的指征,也没有根据术前治疗反应调整术后治疗的指征。免疫治疗唯一被证实的指征是作为食管癌的辅助治疗,但许多研究正在进行,未来可能会改变治疗方法。本综述的目的是综合有关局限性胃食管腺癌管理的文献。