June 5, 2017- The Optimal Timing for Surgery After Neoadjuvant Chemotherapy in Advanced Gastric Cancer

Perioperative chemotherapy is the standard method of care for patients with locally resectable gastric cancer. This is based on the results of the British MAGIC and the French FNCLCC/FDD trails, both of which showed a significant overall survival benefit for those who received perioperative chemotherapy compared to those who only had surgery. For those enrolled in the MAGIC trial, neoadjuvant chemotherapy aided in lowering tumor burden and tumor size, improved the likelihood of resection, and involved less lymph node involvement when compared to those who only received surgery. In the time frame between the completion of chemotherapy and surgery, Dr. Sunnie S.Kim and Dr. Waddah B. Al-Refaie recommend various measures for patients who would benefit from gastrectomy. In order to properly asses the progression of disease CT imaging or PET scans are recommended, sometimes diagnostic laproscopy with peritoneal cytology may also be considered. Nutritional education and counseling is also very important since there are major lifestyle changes that come after surgery, weight loss being one of the major issues. Increased nutritional treatment of weight loss has been associated with significant improvements in survival and complication rates.
Diagnosis & Staging
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