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Practice Guideline
. 2018 Aug;50(8):768-779.
doi: 10.1016/j.dld.2018.04.025. Epub 2018 Jun 6.

Gastric cancer: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO)

Aziz Zaanan  1 , Olivier Bouché  2 , Leonor Benhaim  3 , Bruno Buecher  4 , Nicolas Chapelle  5 , Olivier Dubreuil  6 , Nadim Fares  7 , Victoire Granger  8 , Christine Lefort  9 , Johan Gagniere  10 , Julie Meilleroux  11 , Anne-Sophie Baumann  12 , Veronique Vendrely  13 , Michel Ducreux  14 , Pierre Michel  15 ; Thésaurus National de Cancérologie Digestive (TNCD)
Affiliations
Practice Guideline

Gastric cancer: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO)

Aziz Zaanan et al. Dig Liver Dis. 2018 Aug.

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: French clinical practice guidelines; Gastric cancer.

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