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Review
. 2018;31(2):e1373.
doi: 10.1590/0102-672020180001e1373. Epub 2018 Jul 2.

CURRENT STATUS OF THE MULTIDISCIPLINARY TREATMENT OF GASTRIC ADENOCARCINOMA

[Article in English, Portuguese]
Marcelo Garcia Toneto  1 , Luciana Viola  1
Affiliations
Review

CURRENT STATUS OF THE MULTIDISCIPLINARY TREATMENT OF GASTRIC ADENOCARCINOMA

[Article in English, Portuguese]
Marcelo Garcia Toneto et al. Arq Bras Cir Dig. 2018.

Abstract
in English, Portuguese

Background: The complexity of the management of gastric cancer requires a multidisciplinary evaluation of patients with this tumor. Several treatments have been employed, associated to the surgical resection.

Objective: To review the available therapeutic alternatives for the treatment of gastric adenocarcinoma.

Methods: A review of selected articles on multidisciplinary treatment of gastric adenocarcinoma in the Pubmed and Medline databases between 2000 and 2017 was carried out. The following headings were related: stomach cancer, treatment, chemotherapy and radiotherapy.

Results: There are several valid alternatives, with good results for the treatment of gastric cancer: chemoradiotherapy or chemotherapy in the adjuvant scenario; perioperative chemotherapy; and chemoradiotherapy after neoadjuvance with isolated chemotherapy.

Conclusion: Current evidences suggest that combined multidisciplinary treatment is superior to surgery alone. However, the optimal treatment regimen is not yet established, and depends on a number of factors, especially the type of surgical resection employed. Therefore, the therapeutic decision should be made by a multidisciplinary team, assessing patient's personal characteristics, biology of the tumor, residual disease, risks and side effects.

A complexidade do manejo do câncer gástrico torna necessária a avaliação multidisciplinar dos pacientes com esse tumor. Diversas alternativas de tratamento têm sido empregadas, associadas com a ressecção cirúrgica.

Analisar as alternativas disponíveis para o tratamento do adenocarcinoma gástrico.

Foi realizada revisão de artigos selecionados sobre tratamento multidisciplinar do adenocarcinoma gástrico nas bases de dados Pubmed e Medline entre 2000 e 2017. Os seguintes descritores foram relacionados: câncer de estômago, tratamento, quimioterapia e radioterapia.

Existem várias alternativas válidas, com bons resultados para o tratamento do câncer gástrico: adjuvância com químio e radioterapia ou quimioterapia isolada; quimioterapia perioperatória; e químio e radioterapia após neoadjuvância com quimioterapia isolada.

As evidências sugerem que o tratamento combinado é superior ao da cirurgia isolada. Entretanto, o esquema ideal de tratamento ainda não está estabelecido e depende de uma série de fatores, principalmente o tipo de ressecção cirúrgica empregada. Portanto, a decisão terapêutica deve ser tomada por equipe multidisciplinar, avaliando características pessoais do paciente, biologia do tumor, possibilidade de doença residual, riscos e a capacidade do paciente de tolerar tratamentos não isentos de efeitos colaterais.

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Conflict of interest statement

Conflict of interest: none

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