Asia Pacific Gastroesophageal Cancer Congress (APGCC) 2024 consensus statement on stage 2 and 3 locally advanced gastric and Siewert 3 junctional adenocarcinoma.
Yoshio Masuda, Kang Ler Fong, Danson Yeo, Charleen Yeo, Koy Min Chue, Said Bani Araba, Chiew Woon Lim, Baldwin Yeung, June Lee, Jinlin Lin, Claramae Chia, Matthew Ng, Kennedy Ng, Jens Samol, Daryl Chia, Jun Liang Teh, Raghav Sundar, Wei-Peng Yong, Hon Lyn Tan, Kei Muro, Florian Lordick, Zev Wainburg, Bo Chuan Tan, Guowei Kim, Koichi Suda, Simon Law, Takeshi Sano, Ramesh Gurunathan, Philip Chiu, Emile Woo, Cuong Duong, Han-Kwang Yang, Vo Duy Long, Hyung Ho Kim, Han Alexander Mahendren, Hyuk Joon Lee, Inian Samarasam, Takuji Gotoda, Reis Liew, Asim Shabbir, Myint Oo Aung, Masanori Terashima, Edward Cheong, Jimmy So, Jeremy Tan
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Abstract
Background: While the development in multimodal therapies has helped improve treatment outcomes for patients with locally advanced gastric adenocarcinoma (LAGC), there still exist disparities in opinion with an optimal treatment plan. This consensus hopes to provide clinicians with structured guidelines to aid in the decision-making for treatment options for LAGC.
Methods: The consensus statement was initiated by establishing a taskforce in collaboration with the Asia Pacific Gastroesophageal Cancer Congress (APGCC) and a multidisciplinary expert panel was selected. Clinical questions on LAGC where perceived variance in practice or opinion may exist were formulated. Studies involving patients with Stage 2 or 3 gastric or Siewert 3 junctional cancers with treatment arms of perioperative chemotherapy, neoadjuvant chemotherapy, adjuvant chemotherapy, immunotherapy and surgery were included. A total of two rounds of voting were performed. Consensus was determined to be reached when a single answer or a combination of either "strongly agree/agree" or "strongly disagree/disagree" responses exceeded 75%.
Results: A total of thirteen clinical questions were developed. They were identified through five main categories: Distal LAGC, Proximal LAGC, Deficient mismatch repair tumors, Chemotherapy and Immunotherapy, and Elderly/Unfit patients. After two rounds of voting by our multidisciplinary expert panel, eleven out of a total thirteen clinical questions had reached consensus. No consensus was reached for two clinical questions.
Conclusion: The APGCC consensus statement aims to guide clinicians in the treatment options for LAGC and Siewert 3 junctional cancer and has clarified some of the roles of perioperative chemotherapy and immunotherapy.
期刊介绍：
The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.
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