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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2009

01-04-2009 | Gastrointestinal Oncology

Response to Preoperative Therapy in Upper Gastrointestinal Cancers

Authors: Björn L. D. M. Brücher, MD, PhD, FACS, Stephen G. Swisher, MD, FACS, Alfred Königsrainer, MD, Derek Zieker, MD, Jörg Hartmann, MD, Hubert Stein, MD, Yuko Kitagawa, MD, FACS, Simon Law, MD, FACS, FRCS, Jaffer A. Ajani, MD

Published in: Annals of Surgical Oncology | Issue 4/2009

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Abstract

Background

In cancer, a response to therapy implies a reduction in the volume or activity of localized and/or metastatic tumors. In localized upper gastrointestinal cancer, there is no accepted definition of clinical response; however, tumor shrinkage is frequently observed when preoperative therapy is administered. As patients with upper gastrointestinal cancers often undergo multimodal therapy, it is therefore imperative that new definitions for assessing the response to preoperative therapy be established.

Methods

We reviewed the development of response criteria from a historical perspective, with particular emphasis on the criteria used to assess upper gastrointestinal cancers.

Results

Observing the response to preoperative therapy appears to make it possible to distinguish between favorable and unfavorable clinical biology in the cancer. Patients who experience a response to preoperative treatment appear to fare better in terms of overall survival than those whose cancers do not respond. We reviewed the published results regarding the response to preoperative therapy and the implications of this for patients.

Conclusions

This review of the literature suggests that a variety of tools are available for defining the response to preoperative therapy and that these need to be exploited. Developing reliable methods of assessing the response will improve the individualization of therapy for patients with gastroesophageal cancer. There is a strong need for surrogate markers for efficacy in order to assess responses that are capable of predicting patient outcome.
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Metadata
Title
Response to Preoperative Therapy in Upper Gastrointestinal Cancers
Authors
Björn L. D. M. Brücher, MD, PhD, FACS
Stephen G. Swisher, MD, FACS
Alfred Königsrainer, MD
Derek Zieker, MD
Jörg Hartmann, MD
Hubert Stein, MD
Yuko Kitagawa, MD, FACS
Simon Law, MD, FACS, FRCS
Jaffer A. Ajani, MD
Publication date
01-04-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0315-x

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