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Adjuvant Chemotherapy: An Option for Asian Patients Only?

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Early Gastrointestinal Cancers

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 196))

Abstract

Survival rates following curative resection for gastric cancer are higher in East Asia than in Europe and the US. The aggressive surgical approach adopted in East Asia may explain these observations. In Japan and Korea, gastrectomy with extended lymphadenectomy (D2 gastrectomy) has been standard of care for many years, whereas gastrectomy with lymphadenectomy of the perigastric lymph nodes (D1 surgery) has been favored in Europe and the US until recently. D2 surgery is now recommended globally based on the 15-year findings from the large Dutch D1D2 study, which showed a reduction in cancer-related deaths with D2 versus D1 surgery. Improved outcomes are now being reported in the US and Europe as D2 surgery becomes more widely used. In addition to surgery, systemic therapy is also required to control recurrences, although the preferred regimen differs by region. Given that some of the studies on which these preferences are based predate the widespread acceptance of D2 surgery, the optimal regimen should be considered carefully. Recent studies from East Asia support the use of adjuvant chemotherapy after D2 surgery. Adjuvant chemotherapy should also be considered a valid approach in other regions now that the benefits of D2 surgery have been demonstrated unequivocally.

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Notes

  1. 1.

    The surgery is described as D3 in the published paper, but is D2 surgery according to the current Japanese guidelines.

  2. 2.

    Classification according to International Union Against Cancer (UICC) TMN classification of malignant tumors.

Abbreviations

ACTS-GC:

Adjuvant Chemotherapy Trial of TS-1 for Gastric Cancer

ARTIST:

Adjuvant Chemoradiation Therapy in Stomach Cancer

CLASSIC:

Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer

GASTRIC:

Global Advanced/Adjuvant Stomach Tumor Research International Collaboration

MAGIC:

Medical Research Council Adjuvant Gastric Infusional Chemotherapy

XELOX:

Capecitabine plus oxaliplatin

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Acknowledgments

Support for third-party writing assistance for this manuscript was provided by Roche Korea.

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea

    Yung-Jue Bang

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  1. Yung-Jue Bang
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Correspondence to Yung-Jue Bang .

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Editors and Affiliations

  1. Tumor- und Brustzentrum ZeTuP AG, Rorschacherstr. 150, St. Gallen, 9006, Switzerland

    Florian Otto

  2. Rheinstr. 2, Saarbrücken, 66113, Germany

    Manfred P. Lutz

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© 2012 Springer-Verlag Berlin Heidelberg

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Bang, YJ. (2012). Adjuvant Chemotherapy: An Option for Asian Patients Only?. In: Otto, F., Lutz, M. (eds) Early Gastrointestinal Cancers. Recent Results in Cancer Research, vol 196. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31629-6_19

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  • DOI: https://doi.org/10.1007/978-3-642-31629-6_19

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-31628-9

  • Online ISBN: 978-3-642-31629-6

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