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2016 ; 22
(17
): 4307-20
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Recent developments and innovations in gastric cancer
#MMPMID27158199
Mihmanli M
; Ilhan E
; Idiz UO
; Alemdar A
; Demir U
World J Gastroenterol
2016[May]; 22
(17
): 4307-20
PMID27158199
show ga
Gastric cancer has an important place in the worldwide incidence of cancer and
cancer-related deaths. It can metastasize to the lymph nodes in the early stages,
and lymph node metastasis is an important prognostic factor. Surgery is a very
important part of gastric cancer treatment. A D2 lymphadenectomy is the standard
surgical treatment for cT1N+ and T2-T4 cancers, which are potentially curable.
Recently, the TNM classification system was reorganized, and the margins for
gastrectomy and lymphadenectomy were revised. Endoscopic, laparoscopic and
robotic treatments of gastric cancer have progressed rapidly with development of
surgical instruments and techniques, especially in Eastern countries. Different
endoscopic resection techniques have been identified, and these can be divided
into two main categories: endoscopic mucosal resection and endoscopic submucosal
dissection. Minimally invasive surgery has been reported to be safe and effective
for early gastric cancer, and it can be successfully applied to advanced gastric
cancer with increasing experience. Cytoreductive surgery and hypertherm?c
intraper?toneal chemotherapy were developed as a combined treatment modality from
the results of experimental and clinical studies. Also, hyperthermia increases
the antitumor activity and penetration of chemotherapeutics. Trastuzumab which is
a monoclonal antibody interacts with human epidermal growth factor (HER) 2 and is
related to gastric carcinoma. The anti-tumor mechanism of trastuzumab is not
clearly known, but mechanisms such as interruption of the HER2-mediated cell
signaling pathways and cell cycle progression have been reported previously. H.
pylori is involved in 90% of all gastric malignancies and Japanese guidelines
strongly recommend that all H. pylori infections should be eradicated regardless
of the associated disease. In this review, we present innovations discussed in
recent studies.
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