Universität zu Köln

Moehler, Markus, Baltin, Christoph T. H., Ebert, Matthias, Fischbach, Wolfgang, Gockel, Ines, Grenacher, Lars, Hoelscher, Arnulf H., Lordick, Florian, Malfertheiner, Peter, Messmann, Helmut, Meyer, Hans-Joachim, Palmqvist, Anne, Roecken, Christoph, Schuhmacher, Christoph, Stahl, Michael, Stuschke, Martin, Vieth, Michael, Wittekind, Christian, Wagner, Dorothea and Moenig, Stefan P. (2015). International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus. Gastric Cancer, 18 (3). S. 550 - 564. NEW YORK: SPRINGER. ISSN 1436-3305

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Abstract

Clinical guidelines are essential in implementing and maintaining nationwide stage-specific diagnostic and therapeutic standards. In 2011, the first German expert consensus guideline defined the evidence for diagnosis and treatment of early and locally advanced esophagogastric cancers. Here, we compare this guideline with other national guidelines as well as current literature. The German S3-guideline used an approved development process with de novo literature research, international guideline adaptation, or good clinical practice. Other recent evidence-based national guidelines and current references were compared with German recommendations. In the German S3 and other Western guidelines, adenocarcinomas of the esophagogastric junction (AEG) are classified according to formerly defined AEG I-III subgroups due to the high surgical impact. To stage local disease, computed tomography of the chest and abdomen and endosonography are reinforced. In contrast, laparoscopy is optional for staging. Mucosal cancers (T1a) should be endoscopically resected en-bloc to allow complete histological evaluation of lateral and basal margins. For locally advanced cancers of the stomach or esophagogastric junction (a parts per thousand yenT3N+), preferred treatment is preoperative and postoperative chemotherapy. Preoperative radiochemotherapy is an evidence-based alternative for large AEG type I-II tumors (a parts per thousand yenT3N+). Additionally, some experts recommend treating T2 tumors with a similar approach, mainly because pretherapeutic staging is often considered to be unreliable. The German S3 guideline represents an up-to-date European position with regard to diagnosis, staging, and treatment recommendations for patients with locally advanced esophagogastric cancer. Effects of perioperative chemotherapy versus chemoradiotherapy are still to be investigated for adenocarcinoma of the cardia and the lower esophagus.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moehler, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Baltin, Christoph T. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ebert, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischbach, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Gockel, Ines UNSPECIFIED UNSPECIFIED UNSPECIFIED Grenacher, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lordick, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Malfertheiner, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Messmann, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Hans-Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Palmqvist, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Roecken, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Schuhmacher, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Stahl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Stuschke, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Vieth, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittekind, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wagner, Dorothea UNSPECIFIED UNSPECIFIED UNSPECIFIED Moenig, Stefan P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-400325
DOI:	10.1007/s10120-014-0403-x
Journal or Publication Title:	Gastric Cancer
Volume:	18
Number:	3
Page Range:	S. 550 - 564
Date:	2015
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1436-3305
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LYMPH-NODE DISSECTION; RANDOMIZED CONTROLLED-TRIALS; NEOADJUVANT CHEMOTHERAPY; PERIOPERATIVE CHEMOTHERAPY; PROGNOSTIC-FACTORS; D2 GASTRECTOMY; SURGERY; CHEMORADIOTHERAPY; SURVIVAL; GUIDELINES Multiple languages Oncology; Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40032