The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021

Feng-Hua Wang¹, Xiao-Tian Zhang², Yuan-Fang Li³, Lei Tang⁴, Xiu-Juan Qu⁵, Jie-Er Ying⁶, Jun Zhang⁷, Ling-Yu Sun⁸, Rong-Bo Lin⁹, Hong Qiu¹⁰, Chang Wang¹¹, Miao-Zhen Qiu¹, Mu-Yan Cai¹², Qi Wu¹³, Hao Liu¹⁴, Wen-Long Guan¹, Ai-Ping Zhou¹⁵, Yu-Jing Zhang¹⁶, Tian-Shu Liu¹⁷, Feng Bi¹⁸, Xiang-Lin Yuan¹⁰, Sheng-Xiang Rao¹⁹, Yan Xin²⁰, Wei-Qi Sheng²¹, Hui-Mian Xu²², Guo-Xin Li¹⁴, Jia-Fu Ji²³, Zhi-Wei Zhou³, Han Liang²⁴, Yan-Qiao Zhang²⁵, Jing Jin²⁶, Lin Shen², Jin Li²⁷, Rui-Hua Xu¹

Affiliations

¹ Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
² Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
³ Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
⁴ Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
⁵ Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, P. R. China.
⁶ Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310006, P. R. China.
⁷ Department of Medical Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, P. R. China.
⁸ Department of Surgical Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, P. R. China.
⁹ Department of Medical Oncology, Fujian Cancer Hospital, Fuzhou, Fujian, 350000, P. R. China.
¹⁰ Department of Medical Oncology, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, 430030, P. R. China.
¹¹ Cancer Center of The First Hospital of Jilin University, Changchun, Jilin, 130021, P. R. China.
¹² Department of Pathology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
¹³ Department of Endoscopy Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
¹⁴ Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China.
¹⁵ Department of Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P. R. China.
¹⁶ Department of Radiotherapy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
¹⁷ Department of Medical Oncology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, 200032, P. R. China.
¹⁸ Department of Abdominal Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
¹⁹ Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, P. R. China.
²⁰ Pathology Laboratory of Gastrointestinal Tumor, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, P. R. China.
²¹ Department of Pathology, Zhongshan Hospital Affiliated to Shanghai Fudan University, Shanghai, 200032, P. R. China.
²² Department of Gastrointestinal Oncology Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, P. R. China.
²³ Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
²⁴ Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, P. R. China.
²⁵ Department of Gastrointestinal Medical Oncology, Cancer Hospital of Harbin Medical University, Harbin, Heilongjiang, 150081, P. R. China.
²⁶ Department of Radiation Oncology, Shenzhen Center, Cancer Hospital of Chinese Academy of Medical Sciences, Shenzhen, 518000, P. R. China.
²⁷ Department of Oncology, East Hospital Affiliated to Shanghai Tongji University, Shanghai, 200120, P. R. China.

PMID: 34197702
PMCID: PMC8360643
DOI: 10.1002/cac2.12193

The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021

Feng-Hua Wang et al. Cancer Commun (Lond). 2021 Aug.

. 2021 Aug;41(8):747-795.

doi: 10.1002/cac2.12193. Epub 2021 Jul 1.

Authors

Affiliations

¹ Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
² Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
³ Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
⁴ Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
⁵ Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, P. R. China.
⁶ Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310006, P. R. China.
⁷ Department of Medical Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, P. R. China.
⁸ Department of Surgical Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, P. R. China.
⁹ Department of Medical Oncology, Fujian Cancer Hospital, Fuzhou, Fujian, 350000, P. R. China.
¹⁰ Department of Medical Oncology, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, 430030, P. R. China.
¹¹ Cancer Center of The First Hospital of Jilin University, Changchun, Jilin, 130021, P. R. China.
¹² Department of Pathology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
¹³ Department of Endoscopy Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
¹⁴ Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China.
¹⁵ Department of Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P. R. China.
¹⁶ Department of Radiotherapy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
¹⁷ Department of Medical Oncology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, 200032, P. R. China.
¹⁸ Department of Abdominal Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
¹⁹ Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, P. R. China.
²⁰ Pathology Laboratory of Gastrointestinal Tumor, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, P. R. China.
²¹ Department of Pathology, Zhongshan Hospital Affiliated to Shanghai Fudan University, Shanghai, 200032, P. R. China.
²² Department of Gastrointestinal Oncology Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, P. R. China.
²³ Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, 100142, P. R. China.
²⁴ Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, P. R. China.
²⁵ Department of Gastrointestinal Medical Oncology, Cancer Hospital of Harbin Medical University, Harbin, Heilongjiang, 150081, P. R. China.
²⁶ Department of Radiation Oncology, Shenzhen Center, Cancer Hospital of Chinese Academy of Medical Sciences, Shenzhen, 518000, P. R. China.
²⁷ Department of Oncology, East Hospital Affiliated to Shanghai Tongji University, Shanghai, 200120, P. R. China.

PMID: 34197702
PMCID: PMC8360643
DOI: 10.1002/cac2.12193

Abstract

There exist differences in the epidemiological characteristics, clinicopathological features, tumor biological characteristics, treatment patterns, and drug selections between gastric cancer patients from the Eastern and Western countries. The Chinese Society of Clinical Oncology (CSCO) has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually. Taking into account regional differences, giving full consideration to the accessibility of diagnosis and treatment resources, these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China. The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis, treatment, follow-up, and screening of gastric cancer. Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines, this updated guideline integrates the results of major clinical studies from China and overseas for the past year, focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations. For the comprehensive treatment of non-metastatic gastric cancer, attentions were paid to neoadjuvant treatment. The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated. For the comprehensive treatment of metastatic gastric cancer, recommendations for immunotherapy were included, and immune checkpoint inhibitors from third-line to the first-line of treatment for different patient groups with detailed notes are provided.

Keywords: Chinese Society of Clinical Oncology (CSCO); adjuvant; chemotherapy; diagnosis; gastric cancer; immunotherapy; neoadjuvant; radiotherapy; surgery; targeted therapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

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The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021

Affiliations

The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous