Cancer
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Review Comparative Study
Adjuvant therapy for gastric carcinoma patients in the past 15 years: a review of western and oriental trials.
The early detection of gastric carcinoma is neither feasible nor practiced around the world, except on a limited basis in Japan. Thus, because gastric carcinoma is detected later in most patients throughout the world, those who undergo curative resection still remain at high risk for relapse. Adjuvant therapy therefore has a potentially important place in the treatment of these patients. It has been extensively investigated in the Orient, North America, and Europe. The authors reviewed the results of these trials to determine the current status of adjuvant therapy. ⋯ Postoperative chemotherapy as an adjuvant to potentially curative resection of gastric carcinoma remains investigational despite more than 30 years of investigation in the West. Newer therapeutic combinations or strategies (preoperative chemotherapy or chemoradiotherapy) have the potential to benefit the high risk patients.
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Although in recent years there has been a dramatic increase in both the incidence of ductal carcinoma in situ (DCIS) and breast-conserving therapy for patients who have this disease, the optimal treatment for these patients remains controversial. Most data regarding outcomes have come from small, retrospective studies, with little data published from prospective, randomized studies. This study investigates the effects of age, postoperative breast irradiation, and other factors on local relapse free survival after breast-conserving surgery for women with DCIS in a large, single-institution series. ⋯ In addition to margin status, pathologic factors, and the use of radiation therapy, age is another factor that should be considered in assessing the risk of local recurrence after breast-conserving surgery for patients with DCIS.