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Cancers
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Gastric Cancer: Evolving Landscape and Emerging Therapies
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Gastric Cancer: Evolving Landscape and Emerging Therapies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 14742

Special Issue Editors

Prof. Dr. Takeshi Sano

E-Mail Website
Guest Editor
Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
Interests: gastric cancer; surgery; gastrectomy; clinical trial
Prof. Dr. Stefan Mönig

E-Mail Website
Guest Editor
Visceral Surgery Department, Geneva University Hospital, OH 44041 Geneva, Switzerland
Interests: gastric cancer; esophageal cancer; gastrointestinal surgery

Special Issue Information

Dear Colleagues,

This Special Issue of Cancers will focus on the following aspects:

Epidemiology—changing trends and global disparities: Gastric cancer seems to be a distinct entity in Eastern and Western regions, and in both areas, the rapid decline in Helicobacter pylori infections has changed the incidence of the disease and the spatial distribution of tumors. How has gastric cancer changed across the world? Are we witnessing the future disease landscape for the coming decades?

Pathology—classifications and changing patterns: Gastric cancer has been histologically classified using diverse standards. The recent strides in molecular biology and cancer genomics have enriched our understanding of individual tumor characteristics. Are we going to classify the disease by establishing new standards?

Endoscopy—pioneering diagnostic advances and endoscopic resection: Endoscopic examination is essential for the diagnosis of gastric cancer, and it has undergone significant advancements, enabling precise detection and even on-site histological diagnosis without biopsies. Cutting-edge endoscopic instruments are enabling the aggressive removal of superficial cancers. How far are we proceeding?

Surgery—role in multidisciplinary therapy: Minimally invasive, function-preserving gastrectomy has become widely applicable for early gastric cancer. For locally advanced or even seemingly unresectable cases, a multidisciplinary approach has enhanced resectability and patient survival. What are the present and future roles of surgery within this evolving paradigm?

Systemic therapy—from chemotherapy and immunotherapy to new horizons: As our comprehension of gastric cancer’s biology deepens and immune checkpoint inhibitors rises, systemic therapies are undergoing a revolutionary transformation. Could a future be envisioned where surgery is reserved solely for emergencies?

In summary, this Special Issue will provide deep insight into cutting-edge approaches for gastric cancer.

Prof. Dr. Takeshi Sano
Prof. Dr. Stefan Mönig
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastric cancer
  • epidemiology
  • pathology
  • endoscopy
  • surgery
  • systemic therapy

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Published Papers (5 papers)

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Research

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14 pages, 1038 KiB  
Article
Posterior and Para-Aortic (D2plus) Lymphadenectomy after Neoadjuvant/Conversion Therapy for Locally Advanced/Oligometastatic Gastric Cancer
by Daniele Marrelli, Stefania Angela Piccioni, Ludovico Carbone, Roberto Petrioli, Maurizio Costantini, Valeria Malagnino, Giulio Bagnacci, Gabriele Rizzoli, Natale Calomino, Riccardo Piagnerelli, Maria Antonietta Mazzei and Franco Roviello
Cancers 2024, 16(7), 1376; https://doi.org/10.3390/cancers16071376 - 31 Mar 2024
Cited by 20 | Viewed by 1979
Abstract
Super-extended (D2plus) lymphadenectomy after chemotherapy has been reported in only a few studies. This retrospective study evaluates survival outcomes in a Western cohort of locally advanced or oligometastatic gastric cancer patients who underwent D2plus lymphadenectomy after neoadjuvant chemotherapy. A total of 97 patients [...] Read more.
Super-extended (D2plus) lymphadenectomy after chemotherapy has been reported in only a few studies. This retrospective study evaluates survival outcomes in a Western cohort of locally advanced or oligometastatic gastric cancer patients who underwent D2plus lymphadenectomy after neoadjuvant chemotherapy. A total of 97 patients treated between 2010 and 2022 were included. Of these, 62 had clinical stage II/III disease, and 35 had stage IV disease. Most patients (65%) received preoperative DOC/FLOT chemotherapy. The mean number of lymph nodes harvested was 39. Pathological positive nodes in the posterior/para-aortic stations occurred in 17 (17.5%) patients. Lymphovascular invasion, ypN stage, clinical stage, and perineural invasion were predictive factors for positive posterior/para-aortic nodes. Postoperative complications occurred in 21 patients, whereas severe complications (grade III or more) occurred in 9 cases (9.3%). Mortality rate was 1%. Median overall survival (OS) was 59 months (95% CI: 13–106), with a five-year survival rate of 49 ± 6%; the five-year OS after R0 surgery was 60 ± 7%. In patients with positive posterior/para-aortic nodes, the median OS was 15 months (95% CI: 13–18). D2plus lymphadenectomy after chemotherapy for locally advanced or oligometastatic gastric cancer is feasible and associated with low morbidity/mortality rates. The incidence of pathological metastases in posterior/para-aortic nodes is not negligible even after systemic chemotherapy, with poor long-term survival. Full article
(This article belongs to the Special Issue Gastric Cancer: Evolving Landscape and Emerging Therapies)
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Review

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15 pages, 1039 KiB  
Review
Systemic Therapy of Gastric Cancer—State of the Art and Future Perspectives
by Florian Lordick, Sun Young Rha, Kei Muro, Wei Peng Yong and Radka Lordick Obermannová
Cancers 2024, 16(19), 3337; https://doi.org/10.3390/cancers16193337 - 29 Sep 2024
Cited by 5 | Viewed by 2449
Abstract
Background: The prognosis of patients diagnosed with locally advanced and metastatic gastric and esophago-gastric junction cancer is critical. The optimal choice of systemic therapy is essential to optimize survival outcomes. Methods: A comprehensive literature review via PubMed and analysis of major oncology [...] Read more.
Background: The prognosis of patients diagnosed with locally advanced and metastatic gastric and esophago-gastric junction cancer is critical. The optimal choice of systemic therapy is essential to optimize survival outcomes. Methods: A comprehensive literature review via PubMed and analysis of major oncology congresses (European Society for Medical Oncology and American Society of Clinical Oncology websites) were conducted to ascertain the current status and latest developments in the systemic treatment of patients with localized or advanced gastric and esophago-gastric junction adenocarcinoma. Results: While neoadjuvant and perioperative chemotherapy for localized tumor stages is the preferred approach in the Western Hemisphere, adjuvant chemotherapy remains the preferred course of action in East Asia. The administration of chemotherapy, typically in the form of combinations comprising platinum and fluoropyrimidine compounds in combination with docetaxel, represents a standard of care. Investigations are underway into the potential of immunotherapy and other biologically targeted agents in the perioperative setting. To select the most appropriate therapy for advanced gastric cancer, including adenocarcinoma of the esophago-gastric junction, it is essential to determine biomarkers such as HER2 expression, PD-L1 combined positive score (CPS) (combined positive score), Claudin 18.2, and microsatellite instability (MSI). In the present clinical context, the standard first-line therapy is a combination of fluoropyrimidine and a platinum derivative. The selection of chemotherapy in combination with antibodies is contingent upon the specific biomarker under consideration. Conclusions: This article reviews the current state of the art based on recent clinical trial results and provides an outlook on the future of systemic therapy. Full article
(This article belongs to the Special Issue Gastric Cancer: Evolving Landscape and Emerging Therapies)
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11 pages, 5478 KiB  
Review
Epidemiology of Gastric Cancer—Changing Trends and Global Disparities
by Manami Inoue
Cancers 2024, 16(17), 2948; https://doi.org/10.3390/cancers16172948 - 24 Aug 2024
Cited by 6 | Viewed by 2849
Abstract
Overall, the past century has seen a substantial decline in gastric cancer, attributable to decreases in risk factors such as H. pylori infection, tobacco smoking, and the intake of salt-preserved food. One potential preventive strategy for those at high risk is H. pylori [...] Read more.
Overall, the past century has seen a substantial decline in gastric cancer, attributable to decreases in risk factors such as H. pylori infection, tobacco smoking, and the intake of salt-preserved food. One potential preventive strategy for those at high risk is H. pylori eradication for infected subjects, but confirmation of this effect awaits longer follow-up. Obesity continues to advance and may cause increases in cardia cancer, particularly in Western populations, and careful monitoring of this outcome is warranted in both Western and Asian populations. These changes in gastric cancer epidemiology foreshadow a new era in gastric cancer control and warrant further monitoring of descriptive patterns and risk factors. Full article
(This article belongs to the Special Issue Gastric Cancer: Evolving Landscape and Emerging Therapies)
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16 pages, 1082 KiB  
Review
Gastric Cancer Surgery: Balancing Oncological Efficacy against Postoperative Morbidity and Function Detriment
by Andrianos Tsekrekos, Yasuhiro Okumura, Ioannis Rouvelas and Magnus Nilsson
Cancers 2024, 16(9), 1741; https://doi.org/10.3390/cancers16091741 - 29 Apr 2024
Cited by 1 | Viewed by 2181
Abstract
Significant progress has been made in the surgical management of gastric cancer over the years, and previous discrepancies in surgical practice between different parts of the world have gradually lessened. A transition from the earlier period of progressively more extensive surgery to the [...] Read more.
Significant progress has been made in the surgical management of gastric cancer over the years, and previous discrepancies in surgical practice between different parts of the world have gradually lessened. A transition from the earlier period of progressively more extensive surgery to the current trend of a more tailored and evidence-based approach is clear. Prophylactic resection of adjacent anatomical structures or neighboring organs and extensive lymph node dissections that were once assumed to increase the chances of long-term survival are now performed selectively. Laparoscopic gastrectomy has been widely adopted and its indications have steadily expanded, from early cancers located in the distal part of the stomach, to locally advanced tumors where total gastrectomy is required. In parallel, function-preserving surgery has also evolved and now constitutes a valid option for early gastric cancer. Pylorus-preserving and proximal gastrectomy have improved the postoperative quality of life of patients, and sentinel node navigation surgery is being explored as the next step in the process of further refining the minimally invasive concept. Moreover, innovative techniques such as indocyanine green fluorescence imaging and robot-assisted gastrectomy are being introduced in clinical practice. These technologies hold promise for enhancing surgical precision, ultimately improving the oncological and functional outcomes. Full article
(This article belongs to the Special Issue Gastric Cancer: Evolving Landscape and Emerging Therapies)
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12 pages, 16590 KiB  
Review
Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer
by Mitsuhiro Fujishiro
Cancers 2024, 16(5), 1039; https://doi.org/10.3390/cancers16051039 - 3 Mar 2024
Cited by 3 | Viewed by 4752
Abstract
Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-H. pylori IgG antibody values is very promising. After the detection of suspicious lesions of [...] Read more.
Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-H. pylori IgG antibody values is very promising. After the detection of suspicious lesions of EGC, a detailed observation using magnifying endoscopy with band-limited light is necessary, which reveals an irregular microsurface and/or an irregular microvascular pattern with demarcation lines in the case of cancerous lesions. Endocytoscopy enables us to make an in vivo histological diagnosis. In terms of the indications for endoscopic resection, the likelihood of lymph node metastasis and technical difficulties in en bloc resection is considered, and they are divided into absolute, expanded, and relative indications. Endoscopic mucosal resection and endoscopic submucosal dissection are the main treatment modalities nowadays. After endoscopic resection, curability is evaluated histologically as endoscopic curability (eCura) A, B, and C (C-1 and C-2). Recent evidence suggests that the outcomes of endoscopic resection for many EGCs are comparable to those of gastrectomy and that endoscopic resection is the gold standard for node-negative early gastric cancers. Personalized medicine is also being developed to overcome the unmet needs in treatments of EGC, for example the further expansion of indications and newer resection techniques, such as full-thickness resection. Full article
(This article belongs to the Special Issue Gastric Cancer: Evolving Landscape and Emerging Therapies)
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