{"id":8028,"date":"2025-05-17T13:45:52","date_gmt":"2025-05-17T11:45:52","guid":{"rendered":"https:\/\/gastropedia.pub\/es\/?p=8028"},"modified":"2025-05-17T18:45:37","modified_gmt":"2025-05-17T16:45:37","slug":"flujograma-de-tratamiento-del-cancer-gastrico","status":"publish","type":"post","link":"https:\/\/gastropedia.pub\/es\/cirugia\/flujograma-de-tratamiento-del-cancer-gastrico\/","title":{"rendered":"Flujograma de tratamiento del c\u00e1ncer g\u00e1strico"},"content":{"rendered":"

La Asociaci\u00f3n Japonesa de C\u00e1ncer G\u00e1strico (JGCA) publica peri\u00f3dicamente sus directrices para el tratamiento del c\u00e1ncer g\u00e1strico (CG). La sexta y \u00faltima edici\u00f3n fue publicada en ingl\u00e9s en la revista Gastric Cancer<\/em> en 2022 (1). La figura a continuaci\u00f3n muestra estas directrices de forma adaptada incorporando algunas directrices occidentales.<\/p>\n

\"\"<\/p>\n

*Abreviaturas: CY1: citologia positiva peritoneal; Dif: Diferenciado; Ind: Indiferenciado; LN: linfonodo; RE: resecci\u00f3n endosc\u00f3pica; Ul(-): sin \u00falcera; Ul(+): con \u00falcera<\/p>\n

Algunos puntos merecen destacarse:<\/strong><\/h2>\n

No hubo cambio en los criterios de indicaci\u00f3n para el tratamiento endosc\u00f3pico y los criterios de cura endosc\u00f3pica (eCURA) incorporados en la 5\u00aa edici\u00f3n siguen presentes.<\/p>\n

Otro punto interesante fue la posibilidad de quimioterapia de conversi\u00f3n para enfermedad oligometast\u00e1sica. La definici\u00f3n de enfermedad oligometast\u00e1sica a\u00fan es controvertida. En la directriz japonesa se consider\u00f3 la posibilidad de conversi\u00f3n para el compromiso de los ganglios linf\u00e1ticos cadenas 16a2 y 16b1, met\u00e1stasis hep\u00e1tica resecable, citolog\u00eda oncol\u00f3gica peritoneal positiva y carcinomatosis peritoneal restringida (p1). Recientemente, un grupo de trabajo europeo defini\u00f3 el CG oligometast\u00e1sico cuando est\u00e1 restringido a un \u00f3rgano con \u2264 3 met\u00e1stasis o 1 sitio de met\u00e1stasis linf\u00e1tica a distancia (2). El verdadero beneficio de la cirug\u00eda de conversi\u00f3n para estos pacientes probablemente ser\u00e1 aclarado por el estudio alem\u00e1n prospectivo aleatorizado FLOT5 que a\u00fan est\u00e1 en curso. Este estudio compara un grupo sometido a tratamiento quimioterap\u00e9utico exclusivo con un grupo sometido a quimioterapia de conversi\u00f3n seguida de gastrectom\u00eda (3).<\/p>\n

Por \u00faltimo, vale la pena destacar la quimioterapia neoadyuvante para tumores avanzados y\/o con met\u00e1stasis linf\u00e1ticas. En las directrices japonesas, la indicaci\u00f3n de quimioterapia neoadyuvante ocurre solo en presencia de linfonodos “bulky<\/em>“. Sin embargo, en occidente es cada vez m\u00e1s com\u00fan la indicaci\u00f3n de neoadyuvancia\/preoperatoria incluso en casos sin bulky<\/em> linf\u00e1tico.<\/p>\n

Referencias<\/h2>\n
    \n
  1. Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition). Gastric Cancer. 2023;26(1):1-25.<\/li>\n
  2. Kroese TE, van Laarhoven HWM, Schoppman SF, Deseyne P, van Cutsem E, Haustermans K, et al. Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe. Eur J Cancer. 2023;185:28-39.<\/li>\n
  3. Al-Batran SE, Goetze TO, Mueller DW, Vogel A, Winkler M, Lorenzen S, et al. The RENAISSANCE (AIO-FLOT5) trial: effect of chemotherapy alone vs. chemotherapy followed by surgical resection on survival and quality of life in patients with limited-metastatic adenocarcinoma of the stomach or esophagogastric junction \u2013 a phase III trial of the German AIO\/CAO-V\/CAOGI. BMC Cancer. 2017;17(1):893.<\/li>\n<\/ol>\n

    C\u00f3mo citar este art\u00edculo<\/h2>\n

    Ramos MFKP; Gamarra ACQ. Diagrama de flujo del tratamiento del c\u00e1ncer g\u00e1strico Gastropedia 2025. Disponible en: https:\/\/gastropedia.pub\/es\/cirugia\/flujograma-de-tratamiento-del-cancer-gastrico\/<\/p>\n","protected":false},"excerpt":{"rendered":"

    La Asociaci\u00f3n Japonesa de C\u00e1ncer G\u00e1strico (JGCA) publica peri\u00f3dicamente sus directrices para el tratamiento del c\u00e1ncer g\u00e1strico (CG). La sexta y \u00faltima edici\u00f3n fue publicada en ingl\u00e9s en la revista…<\/p>\n","protected":false},"author":5595,"featured_media":7999,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"categories":[24,27],"tags":[],"ano":[407],"tipo":[121],"volumen":[57],"class_list":["post-8028","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cirugia","category-esofago-estomago-duodeno","ano-407","tipo-temas-generales","volumen-volume-i"],"yoast_head":"\nFlujograma de tratamiento del c\u00e1ncer g\u00e1strico - Gastropedia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/gastropedia.pub\/es\/cirugia\/flujograma-de-tratamiento-del-cancer-gastrico\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Flujograma de tratamiento del c\u00e1ncer g\u00e1strico\" \/>\n<meta property=\"og:description\" content=\"La Asociaci\u00f3n Japonesa de C\u00e1ncer G\u00e1strico (JGCA) publica peri\u00f3dicamente sus directrices para el tratamiento del c\u00e1ncer g\u00e1strico (CG). 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