Department of Pathology, APHP, Saint-Antoine Hospital, Sorbonne University, SIRIC CURAMUS, Paris, France.
Digestive Surgery Department, APHP, Saint-Antoine Hospital, Sorbonne University, SIRIC CURAMUS, Paris, France.
Lancet Oncol. 2024 Sep;25(9):e452-e463. doi: 10.1016/S1470-2045(24)00180-3.
Despite our increased understanding of the biological and molecular aspects of gastro-oesophageal tumourigenesis, the identification of prognostic or predictive factors remains challenging. Patients with resectable gastric and oesophageal adenocarcinoma are often treated similarly after surgical resection, regardless of their tumour biology, clinical characteristics, and histological treatment response. Substantial progress has been made in the past 5 years in managing patients with gastric or oesophageal adenocarcinoma, including the use of immune checkpoint inhibitors and new targeted therapies, leading to substantial improvements in clinical outcomes. These advancements have primarily been established in advanced and metastatic disease, while the management framework for local and locoregional disease is just beginning to shift. We provide an overview of existing data on biomarkers and tumour-related and host-related factors that are relevant to stratify patients into low-risk and high-risk recurrence groups, both before and after surgery, paving the way for more personalised treatment approaches.
尽管我们对胃食管肿瘤发生的生物学和分子方面有了更多的了解，但预测或预后因素的识别仍然具有挑战性。可切除的胃和食管腺癌患者在手术后通常接受类似的治疗，而不论其肿瘤生物学、临床特征和组织学治疗反应如何。在过去 5 年中，在管理胃或食管腺癌患者方面取得了重大进展，包括使用免疫检查点抑制剂和新的靶向治疗，这导致临床结果有了实质性的改善。这些进展主要是在晚期和转移性疾病中建立的，而局部和局部区域疾病的管理框架才刚刚开始转变。我们提供了有关生物标志物以及与肿瘤相关和宿主相关的因素的现有数据概述，这些因素与在手术前后将患者分层为低风险和高风险复发组相关，为更个性化的治疗方法铺平了道路。
