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- Title
Indian Council of Medical Research consensus document for the management of gastric cancer.
- Authors
Shrikhande, Shailesh V.; Sirohi, Bhawna; Barreto, Savio G.; Chacko, Raju T.; Parikh, Purvish M.; Pautu, Jeremy; Arya, Supreeta; Patil, Prachi; Chilukuri, Srinivas C.; Ganesh, B.; Kaur, Tanvir; Shukla, Deepak; Rath, Goura Shankar
- Abstract
The document is based on consensus among the experts and best available evidence pertaining to Indian population and is meant for practice in India. Evaluation of a patient with newly diagnosed gastric cancer should include essential tests: A standard white light endoscopy with multiple biopsies from the tumor for confirmation of the diagnosis, a computed tomography (CT) scan (multi-detector or helical) of the abdomen and pelvis for staging with a CT chest or chest X-ray, and complete blood counts, renal and liver function tests. Endoscopic ultrasonography/ magnetic resonance imaging/positron emission tomography-CT is not recommended for all patients. For early stage disease (IA/B, N0), surgery alone is recommended. The need for adjuvant treatment would be guided by the histopathological analysis of the resected specimen. For locally advanced stage (IB, N+ to IIIC), neoadjuvant chemotherapy may be considered to downstage the disease followed by surgery. This may be followed by adjuvant chemotherapy (as part of the peri-operative chemotherapy regimen). Patients with stage IV/metastatic disease must be assessed for chemotherapy versus best supportive care on an individual basis. Clinical examination including history and physical examination are recommended at each follow-up visit, with a yearly CT scan of the chest, abdomen, and pelvis. HER2 testing should be considered in patients with metastatic disease. 5-FU may be replaced with capecitabine if patients do not have gastric outlet obstruction. Cisplatin may be replaced with oxaliplatin in the regimens.
- Subjects
STOMACH cancer treatment; INDIAN Council of Medical Research (Organization); OXALIPLATIN; COMPUTED tomography; FOLLOW-up studies (Medicine); CISPLATIN; HER2 gene; THERAPEUTICS
- Publication
Indian Journal of Medical & Paediatric Oncology, 2014, Vol 35, Issue 4, p239
- ISSN
0971-5851
- Publication type
Article
- DOI
10.4103/0971-5851.144970