| Theme |
Diagnosis and Treatment of Scirrhous Gastric Cancer -- Current Status and Future Prospects |
| Title |
Treatment for Scirrhous Type Gastric Cancer : Neoadjuvant Chemotherapy and Adjuvant Chemotherapy |
| Author |
Chikara Kunisaki |
Department of Surgery, Gastroenterological Center, Yokohama City University |
| Author |
Hidetaka Ono |
Department of Surgery, Gastroenterological Center, Yokohama City University |
| Author |
Takashi Kosaka |
Department of Gastroenterological Surg., Yokohama City University, Graduate School of Medicine |
| Author |
Hirochika Makino |
Department of Gastroenterological Surg., Yokohama City University, Graduate School of Medicine |
| Author |
Hirotoshi Akiyama |
Department of Gastroenterological Surg., Yokohama City University, Graduate School of Medicine |
| Author |
Itaru Endo |
Department of Gastroenterological Surg., Yokohama City University, Graduate School of Medicine |
| [ Summary ] |
An effective therapeutic strategy for scirrrhous type gastric cancer has not been established. Recently, the SPIRITS trial showed that S-1 plus CDDP combination therapy is superior as compared to S-1 monotherapy for treatment of advanced gastric cancer. Subsequently this therapy is regarded as the standard for advanced gastric cancer treatment in Japan. By contrast, the START trial failed to exhibit successful outcomes for the treatment of advanced cancer. The progression of free survival in the S-1/DOC group was significantly longer than that in the S-1 group although there was no significant difference in overall survival rates between the two groups. Considering the biological malignant potential for scirrhous type gastric cancer, these regimens may be candidates for treatment for scirrhous type gastric cancer as neoadjuvant or adjuvant forms of chemotherapy. Moreover, outcomes for intraperitoneal chemotherapy can be anticipated for scirrhhous type gastric cancer since peritoneal dissemination is the most frequent recurrent pattern observed with this disease. In the future, targeted therapy using bevacizumab or gene therapy, using adenovirus treatment may be a candidate for the treatment of scirrhous type gastric cancer. |