Multimodal approach in the treatment of generalized malignancies of the gastrointestinal tract

Summary: Background: More than 10,000 patients are diagnosed with malignant tumors of the intestine, pancreas, esophagus and stomach in the Czech Republic each year. A significant proportion of patients relapse or are primary diagnosed at a locally advanced inoperable or metastatic stage. The prognosis of these patients can be influenced by oncological treatment and in many cases also by surgical, endoscopic or radiological intervention. Methods: The article summarizes treatment options of patients with advanced or metastatic malignancies of the gastrointestinal tract from the perspective of oncologist and surgeon in order to present oncological data on prognosis of patients and surgical methods of treatment to other members of the multidisciplinary team. Endoscopic methods are consulted with gastroenterologist. Results: The importance of surgery is not the same for all mentioned cancer types and it is influenced by many variables. The highest benefit of the surgical treatment has resection of liver metastases of colorectal cancer, on the other hand, surgery has only limited palliative impact in pancreatic cancer patients. Conclusions: A multimodal approach to the treatment of tumors of the gastrointestinal tract offers the inclusion of surgical treatment at the present time even where it was not routinely recommended in the past. The condition for the correct indication of surgery is a multidisciplinary assessment of each individual patient. Key words: colorectal cancer – pancreatic cancer – esophageal cancer – stomach cancer – GIT malignancies – relapses – surgergical procedures