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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2014; 35(04): 239-243
DOI: 10.4103/0971-5851.144970
POSITION PAPER

Indian Council of Medical Research consensus document for the management of gastric cancer

Shailesh V. Shrikhande
Department of Surgical Oncology, Kiran Mazumdar Shaw Cancer Centre, Narayana Health, Bangalore, India
,
Bhawna Sirohi
Department of Medical Oncology, Kiran Mazumdar Shaw Cancer Centre, Narayana Health, Bangalore, India
,
Savio G. Barreto
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Raju T. Chacko
Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
,
Purvish M. Parikh
Department of Surgical Oncology, Kiran Mazumdar Shaw Cancer Centre, Narayana Health, Bangalore, India
,
Jeremy Pautu
Department of Medical Oncology, Mizoram Sate Cancer Institute, Aizwal, Mizoram, India
,
Supreeta Arya
Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
,
Prachi Patil
Department of DDCN, Tata Memorial Centre, Mumbai, Maharashtra, India
,
Srinivas C. Chilukuri
Department of Radiotherapy, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
,
B Ganesh
Department of Epidemiology, Tata Memorial Centre, Mumbai, Maharashtra, India
,
Tanvir Kaur
Indian Council of Medical Research, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Shukla
Indian Council of Medical Research, All India Institute of Medical Sciences, New Delhi, India
,
Goura Shankar Rath
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India
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E X E C U T I V E S U M M A R Y

The document is based on consensus among the experts and best available evidence pertaining to Indian population and is meant for practice in India.Evaluation of a patient with newly diagnosed gastric cancer should include essential tests: A standard white light endoscopy with multiple biopsies from the tumor for confirmation of the diagnosis, a computed tomography (CT) scan (multi-detector or helical) of the abdomen and pelvis for staging with a CT chest or chest X-ray, and complete blood counts, renal and liver function tests. Endoscopic ultrasonography/ magnetic resonance imaging/positron emission tomography-CT is not recommended for all patients.For early stage disease (IA/B, N0), surgery alone is recommended. The need for adjuvant treatment would be guided by the histopathological analysis of the resected specimen.For locally advanced stage (IB, N + to IIIC), neoadjuvant chemotherapy may be considered to downstage the disease followed by surgery. This may be followed by adjuvant chemotherapy (as part of the peri-operative chemotherapy regimen)Patients with stage IV/metastatic disease must be assessed for chemotherapy versus best supportive care on an individual basis.Clinical examination including history and physical examination are recommended at each follow-up visit, with a yearly CT scan of the chest, abdomen, and pelvis.HER2 testing should be considered in patients with metastatic disease.5-FU may be replaced with capecitabine if patients do not have gastric outlet obstruction. Cisplatin may be replaced with oxaliplatin in the regimens.>

Keywords

Diagnosis - gastric cancer - guidelines - Indian Council of Medical Research - treatment


Publication History

Article published online:
19 July 2021

© 2014. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Dikshit R, Gupta PC, Ramasundarahettige C, Gajalakshmi V, Aleksandrowicz L, Badwe R, et al. Cancer mortality in India: A nationally representative survey. Lancet 2012;379:1807-16.
  • 2 Kalyani R, Das S, Kumar ML. Pattern of cancer in adolescent and young adults - a ten year study in India. Asian Pac J Cancer Prev 2010;11:655-9.
  • 3 Sarker SK, Sinha VK, Chaudhry R, Maudar KK. Gastric cancer: A critical analysis of surgical treatment and long term survival. J Indian Med Assoc 1992;90:61-4.
  • 4 National Cancer Registry Programme. Three-Year Report of the Population Based Cancer Registries - 2009-2011. National Cancer Registry Programme, Indian Council of Medical Research (ICMR), Bangalore, India; 2013. Available from: http://www.pbcrindia.org. [Last accessed on 2014 Oct 16].
  • 5 Okines A, Verheij M, Allum W, Cunningham D, Cervantes A, ESMO Guidelines Working Group. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010;21 Suppl 5:v50-4.
  • 6 Shen L, Shan YS, Hu HM, Price TJ, Sirohi B, Yeh KH, et al. Management of gastric cancer in Asia: Resource-stratified guidelines. Lancet Oncol 2013;14:e535-47.
  • 7 Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: A systematic review. J Clin Oncol 2007;25: 2107-16.
  • 8 Wang Z, Chen JQ. Imaging in assessing hepatic and peritoneal metastases of gastric cancer: A systematic review. BMC Gastroenterol 2011;11:19.
  • 9 Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): A phase 3, open-label, randomised controlled trial. Lancet 2010;376:687-97.
  • 10 In: Edge, S., Byrd, D.R., Compton, C.C., Fritz, A.G., Greene, F.L., Trotti, A. editors. AJCC Cancer Staging Manual. 7 th ed. New York: Springer Verlag; 2009.
  • 11 Murakami T. Early cancer of the stomach. World J Surg 1979;3:685-92.
  • 12 Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver 3). Gastric Cancer 2011;14:113-23.
  • 13 Wen L, Chen XZ, Wu B, Chen XL, Wang L, Yang K, et al. Total vs. proximal gastrectomy for proximal gastric cancer: A systematic review and meta-analysis. Hepatogastroenterology 2012;59:633-40.
  • 14 Shrikhande SV, Barreto SG, Talole SD, Vinchurkar K, Annaiah S, Suradkar K, et al. D2 lymphadenectomy is not only safe but necessary in the era of neoadjuvant chemotherapy. World J Surg Oncol 2013;11:31.
  • 15 Haverkamp L, Weijs TJ, van der Sluis PC, van der Tweel I, Ruurda JP, van Hillegersberg R. Laparoscopic total gastrectomy versus open total gastrectomy for cancer: A systematic review and meta-analysis. Surg Endosc 2013;27:1509-20.
  • 16 Resection line disease in stomach cancer. British Stomach Cancer Group. Br Med J (Clin Res Ed). 1984;289:601-3.
  • 17 Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11-20.
  • 18 Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 2008;358:36-46.
  • 19 Sirohi B, Barreto S, Singh A, Batra S, Mittra A, Rastogi S, et al. EOX is just as ′MAGIC′al as ECF perioperative chemotherapy for resectable locally advanced gastro-oesophageal cancer. J Cancer Res Ther 2014.
  • 20 Bang YJ, Kim YW, Yang HK, Chung HC, Park YK, Lee KH, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): A phase 3 open-label, randomised controlled trial. Lancet 2012;379:315-21.
  • 21 Smalley SR, Benedetti JK, Haller DG, Hundahl SA, Estes NC, Ajani JA, et al. Updated analysis of SWOG-directed intergroup study 0116: A phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Oncol 2012;30:2327-33.
  • 22 Dikken JL, Jansen EP, Cats A, Bakker B, Hartgrink HH, Kranenbarg EM, et al. Impact of the extent of surgery and postoperative chemoradiotherapy on recurrence patterns in gastric cancer. J Clin Oncol 2010;28:2430-6.
  • 23 Barreto S. Current strategies in the diagnosis and management of resectable gastric adenocarcinoma. Astrocyte 2014;1: 41-9.
  • 24 Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric cancer: A systematic review and meta-analysis based on aggregate data. J Clin Oncol 2006;24:2903-9.
  • 25 Van Cutsem E, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: A report of the V325 Study Group. J Clin Oncol 2006;24:4991-7.
  • 26 Sirohi B, Rastogi S, Dawood S, Talole S, Ramadwar M, Shetty N, et al. Treatment of patients with advanced gastric cancer: Experience from an Indian tertiary cancer center. Med Oncol 2014;31:138.
  • 27 Ford HE, Marshall A, Bridgewater JA, Janowitz T, Coxon FY, Wadsley J, et al. Docetaxel versus active symptom control for refractory oesophagogastric adenocarcinoma (COUGAR-02): An open-label, phase 3 randomised controlled trial. Lancet Oncol 2014;15:78-86.
  • 28 Satoh T, Lee KH, Rha SY, Sasaki Y, Park SH, Komatsu Y, et al. Randomized phase II trial of nimotuzumab plus irinotecan versus irinotecan alone as second-line therapy for patients with advanced gastric cancer. Gastric Cancer 2014.
  • 29 Khan SA, Tyagi M, Sharma AK, Barreto SG, Sirohi B, Ramadwar M, et al. Cell-type specificity of ß-actin expression and its clinicopathological correlation in gastric adenocarcinoma. World J Gastroenterol 2014;20:12202-11.