Pubblicazioni

Autori:

Morgagni, Paolo; Bencivenga, Maria; Carneiro, Fatima; Cascinu, Stefano; Derks, Sarah; Di Bartolomeo, Maria; Donohoe, Claire; Eveno, Clarisse; Gisbertz, Suzanne; Grimminger, Peter; Gockel, Ines; Grabsh, Heike; Kassab, Paulo; Langer, Rupert; Lonardi, Sara; Maltoni, Marco; Markar, Sheraz; Moehler, Markus; Marrelli, Daniele; Mazzei, Maria Antonietta; Melisi, Davide; Milandri, Carlo; Moenig, Paul Stefan; Mostert, Bianca; Mura, Gianni; Polkowski, Wojciech; Reynolds, John; Saragoni, Luca; Van Berge Henegouwen, Mark I; Van Hillegersberg, Richard; Vieth, Michael; Verlato, Giuseppe; Torroni, Lorena; Wijnhoven, Bas; Tiberio, Guido Alberto Massimo; Yang, Han-Kwang; Roviello, Franco; de Manzoni, Giovanni

Titolo:

International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape : Bertinoro Workshop, November 2022

Anno:

2024

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Referee:

No

Nome rivista:

Gastric Cancer

ISSN Rivista:

1436-3291

N° Volume:

27

Numero o Fascicolo:

4

Intervallo pagine:

649-671

Parole chiave:

Consensus; Multimodal treatment; Oligometastatic gastric cancer; Stage IV; Staging

Breve descrizione dei contenuti:

Background: Many gastric cancer patients in Western countries are diagnosed as metastatic with a median overall survival of less than twelve months using standard chemotherapy. Innovative treatments, like targeted therapy or immunotherapy, have recently proved to ameliorate prognosis, but a general agreement on managing oligometastatic disease has yet to be achieved. An international multi-disciplinary workshop was held in Bertinoro, Italy, in November 2022 to verify whether achieving a consensus on at least some topics was possible. Methods: A two-round Delphi process was carried out, where participants were asked to answer 32 multiple-choice questions about CT, laparoscopic staging and biomarkers, systemic treatment for different localization, role and indication of palliative care. Consensus was established with at least a 67% agreement. Results: The assembly agreed to define oligometastases as a "dynamic" disease which either regresses or remains stable in response to systemic treatment. In addition, the definition of oligometastases was restricted to the following sites: para-aortic nodal stations, liver, lung, and peritoneum, excluding bones. In detail, the following conditions should be considered as oligometastases: involvement of para-aortic stations, in particular 16a2 or 16b1; up to three technically resectable liver metastases; three unilateral or two bilateral lung metastases; peritoneal carcinomatosis with PCI ≤ 6. No consensus was achieved on how to classify positive cytology, which was considered as oligometastatic by 55% of participants only if converted to negative after chemotherapy. Conclusion: As assessed at the time of diagnosis, surgical treatment of oligometastases should aim at R0 curativity on the entire disease volume, including both the primary tumor and its metastases. Conversion surgery was defined as surgery on the residual volume of disease, which was initially not resectable for technical and/or oncological reasons but nevertheless responded to first-line treatment.

Note:

Epub 2024 Apr 18

Id prodotto:

139079

Handle IRIS:

11562/1125011

ultima modifica:

27 giugno 2024

Citazione bibliografica:

Morgagni, Paolo; Bencivenga, Maria; Carneiro, Fatima; Cascinu, Stefano; Derks, Sarah; Di Bartolomeo, Maria; Donohoe, Claire; Eveno, Clarisse; Gisbertz, Suzanne; Grimminger, Peter; Gockel, Ines; Grabsh, Heike; Kassab, Paulo; Langer, Rupert; Lonardi, Sara; Maltoni, Marco; Markar, Sheraz; Moehler, Markus; Marrelli, Daniele; Mazzei, Maria Antonietta; Melisi, Davide; Milandri, Carlo; Moenig, Paul Stefan; Mostert, Bianca; Mura, Gianni; Polkowski, Wojciech; Reynolds, John; Saragoni, Luca; Van Berge Henegouwen, Mark I; Van Hillegersberg, Richard; Vieth, Michael; Verlato, Giuseppe; Torroni, Lorena; Wijnhoven, Bas; Tiberio, Guido Alberto Massimo; Yang, Han-Kwang; Roviello, Franco; de Manzoni, Giovanni, International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape : Bertinoro Workshop, November 2022 «Gastric Cancer» , vol. 27 , n. 4 , 2024 , pp. 649-671

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo