“Neoadjuvant chemoradiotherapy followed by surgery is currently considered an important multimodality treatment option for patients with locally advanced esophageal or gastroesophageal junction cancer. Perioperative chemotherapy is an alternative multimodality treatment option for locally advanced gastroesophageal junction
adenocarcinoma.”
“In this retrospective study, all patients who had gastrectomy for cancer between 2007 and 2017 in French tertiary centers were included. The outcome was a diagnosis of GLP based on pathological review of the surgical specimen. The diagnostic score was created by using variables that were most frequently associated with GLP using penalized logistic
regression on multiply imputed datasets. We used discrimination measures to assess the performances of the score. Internal validation was performed using bootstrapping methods to correct for over-optimism.”
“The diagnosis of LP carries significant controversy regarding its surgical management.
Lymph node involvement is almost always present at the time of diagnosis, and due to its
diffuse nature, microscopic disease is often found at the resection margins. Peritoneal
dissemination is frequently encountered at the time of surgery or as the main site of
recurrence. As such, curative resection is possible in less than half of patients and early
recurrence is common, leading to a dismal median survival, ranging from 6 to 12 months,
and 5-year survival between 8 and 13 %.”
“Linitis plastica (LP) is a distinct phenotype of gastric cancer. Macroscopically, it is characterized as a thickened stomach, with prominent diffusion of the tumor into the submucosal and muscular layers; microscopically, it is often associated with signet ring cell features and diffuse and scirrhous (referring to the histologic characteristic of abundant stromal cells) histologic types.”
“Linitis plastica due to gastric adenocarcinoma is a condition with a long history, but still lacks a standardized definition and is commonly confused with Borrmann type IV, Lauren diffuse, and signet-cell type gastric cancer. The absence of a clear definition is a problem when investigating its biological characteristics and role as a possible independent factor for prognosis. Nevertheless, the biological behavior for linitis plastica, which is unique, may be valuable in risk stratification and have implications for treatment. A definition of linitis plastica
based on molecular or genomic criteria could represent a useful starting point for investigating new targeted therapies.”
“The Siewert classification is widely used for determining which surgical procedure is used, because previous studies have shown that the pattern of lymph node (LN) metastasis depends on tumor location. In terms of surgical approaches for GEJ adenocarcinoma, a consensus was reached based on two randomized controlled trials. Siewert types I and III are treated as esophageal cancer and gastric cancer, respectively.”
“Neoadjuvant chemoradiotherapy (nCRT) followed by surgery is currently considered an important multimodality treatment option for patients with locally advanced esophageal or gastroesophageal junction cancer. Perioperative chemotherapy is an alternative multimodality treatment option for locally advanced gastroesophageal junction adenocarcinoma. The overall survival of patients with locally advanced esophageal or gastroesophageal junction cancer treated with nCRT followed by surgery remains relatively poor with an estimated 5-year OS rate of 40% to 50%, predominantly due to distant recurrences.”
Surgical Focus 