An update in the nonendoscopic treatment of gastric cancer

This article reviews the recent seminal studies in esophagogastric cancer.

Regular low aspirin use may reduce the risk of esophagogastric cancer. Laparoscopic resection of locally advanced gastric cancer appears equivalent to open resection. There is no survival benefit for the addition of postoperative radiation therapy to adjuvant chemotherapy after primary gastric cancer resection. For tumors of the esophagus and gastroesophageal junction, the combination of preoperative radiation therapy with concurrent chemotherapy may be required to ensure achievement of a negative surgical margin and to reduce local tumor recurrence. Epirubicin may not add benefit to fluorinated pyrimidine and platinum-based chemotherapy, either in the preoperative setting or in the treatment of metastatic disease. The Her2-targeted agents lapatinib and trastuzumab emtansine failed to improve outcome when either added to or compared with chemotherapy. Immune checkpoint inhibition appears to be active in metastatic gastric cancer.

Recent studies in esophagogastric cancer help clarify the role of radiation therapy in surgical management, as well as the role of chemotherapeutic and targeted agents.