Abstract
Introduction
This document is a summary of the French Intergroup guidelines regarding the management
of gastric cancer published in October 2016, available on the website of the French
Society of Gastroenterology (SNFGE) (www.tncd.org), updated in October 2017.
Methods
This collaborative work was realized under the auspices of several French medical
societies involved in management of gastric cancer. Recommendations are graded in
three categories (A–C), according to the amount of evidence found in the literature
until July 2017.
Results
There are several known risk factors for gastric cancer, including Helicobacter pylori and genetic predispositions, both requiring a specific screening for patients and
their relatives. The diagnosis and staging evaluation are essentially based on gastroscopy
plus biopsies and computed tomography scan. The endoscopic ultrasonography can be
used for superficial tumors in case of discussion for endoscopic resection (T1N0).
For local disease (N+ and/or T > T1), the strategic therapy is based on surgery associated
with perioperative chemotherapy. In the absence of preoperative treatment (for any
raison), the postoperative chemoradiotherapy (or chemotherapy) should be discussed
for patients with stage II or III tumor. For metastatic disease, the treatment is
based on “palliative” chemotherapy consisting in a doublet or triplet regimens depending
of age, performance status and HER2 tumor status. For patients with limited metastatic
disease, surgical resection could be discussed in multidisciplinary meeting in case
of stable disease after chemotherapy.
Conclusion
These guidelines in gastric cancer are done to help decision for daily clinical practice.
These recommendations are permanently being reviewed. Each individual case must be
discussed within a multidisciplinary team.
Keywords
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Article info
Publication history
Published online: May 10, 2018
Accepted:
April 26,
2018
Received:
January 27,
2018
Identification
Copyright
© 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
