The 15th International Gastric Cancer Congress (IGCC 2023)第15回国際胃癌学会

Several pivotal trials have established the clinical significance of laparoscopic and robotic gastrectomy for advanced gastric cancer. However, the surgical procedures for advanced gastric cancer differ from those for early stage disease, and have yet to be standardized. In this session, experts will share their surgical procedures as a step toward standardization.

There are multiple surgical approaches for GEJ cancer, including transthoracic and transhiatal, based on the tumor location and distribution of lymph node metastasis. Furthermore, various reconstruction procedures exist, including for the same tumor location. In this session, surgical skills for GEJ cancer lymphadenectomy and reconstruction.

Fluorescent endoscopic surgery using ICG has been widely used for identifying the sentinel lymph node, or determining the extent of lymphadenectomy. It enables us to determine the optimal resection line during gastrectomy, but the present status of navigation surgery and its indication remain unclear. This session will discuss the technique of navigation surgery and its outcomes.

Enhanced recovery after surgery (ERAS) is shown to help shorten the length of hospitalization, accelerate postoperative recovery, and reduce surgical stress. The ERAS protocols comprise many items, including pre-operative patient education, and early mobilization and feeding starting from the first postoperative day. The purpose of this session is to discuss the applicability of ERAS and optimal nutrition support after gastrectomy.

In addition to oncological outcomes, health-related quality of life is considered an important endpoint after gastrectomy. Several types of PROs, such as EORTC and FACT, are being used in the measurement of QOL. This session will discuss the optimal PRO for gastric cancer patients, and the feasibility of personalized care for specific patients using these PROs.

Immunotherapy has been accepted as a standard treatment for gastric cancer. The indication and updated evidence for it will be shared.

Targeted therapy for gastric cancer has been improved, especially for HER2 positive subpopulations. In this session, the current status and future outlook for targeted and systemic therapy for gastric cancer will be shared.

To date, the evidence for biomarker-driven targeted therapy for gastric cancer is limited except for trastuzumab in HER2 positive cancers. ICIs are promising anti-PD-1 antibodies and are widely used in clinical practice; however, biomarkers for these ICIs have not been clearly identified. This session will present clinical and basic research outcomes related to biomarkers and discuss the biomarker-driven therapeutic strategy for the next stage.

The approval of imatinib, a KIT/PDGFRA TKI, has led to improvement of treatment for advanced GIST, and subsequently two additional drugs were approved (sunitinib & regorafenib). However, despite the discovery of the detailed molecular mechanisms of GIST and subfractions with rare driver mutations, the development of TKI resistance was inevitable and continues to be a problem. This session will discuss the pharmacotherapy for advanced/metastatic GIST and its future outlook.

Laparoscopy and endoscopy cooperative surgery (LECS) & endoscopic full thickness resection (EFTR) have been accepted as treatment options for submucocal tumors. In this session, their technical principles and applications will be shared.

The most effective way to improve the prognosis of gastric cancer is early detection. In this session, we hope to receive a wide range of presentations on efforts to narrow down high-risk groups using biomarkers, advances in observation methods such as image-enhanced endoscopy, education, and construction of effective screening systems.

Barrett's esophagus is known to be a precursor of gastro-esophageal junctional adenocarcinoma. Very short-length Barrett's epithelium is often seen even in young subjects, and the individual risk for carcinogenesis remains unclear. This session will discuss appropriate surveillance methods and eradication treatment for Barrett's esophagus.

Endoscopic resection for early gastric cancer is an excellent treatment with curative and minimal invasiveness. However, there are still technically challenging lesions, and there are proposals for expanding its indication as a local treatment for elderly patients and patients with comorbidities. In this session, we will discuss the latest findings in endoscopic treatment of gastric and GEJ cancer.

Radiotherapy is one of the key modalities for advanced gastric cancer. This session will discuss the current evidence and future outlook for multimodality therapy with radiotherapy for gastric cancer.

Proactive palliative care is widely known to effectively relieve symptoms and improve the quality of life of gastric cancer patients. However, problems that need to be managed by endoscopy, surgery, or radiotherapy, such as malignant gastric outlet obstruction or severe bleeding, may occur. This session will discuss optimal supportive and palliative therapies for gastric cancer patients.

Signet-ring cell was redefined as an independent histological type in the 5th edition of the WHO Classification of Tumors, after being temporarily regarded as a subtype of poorly cohesive carcinoma in the 4th edition. The consideration of subtype-specific medical therapy for gastric cancer is becoming increasingly important. This session will examine the refinement of poorly cohesive cancers in the WHO classification and its impact.

Now that molecular profiling has been established, it now needs to be merged into a pathological classification that is the golden standard. In this session, the ideal molecular and pathological classifications for gastric and GEJ cancer will be discussed.

Comprehensive approach is one of the representative tactics for translational research. The current status of omic medicine combining genomics, proteomics, and metabolomics will be presented.

Advances in translational research have improved the treatment outcomes for gastric cancer. Precision medicine with genomic profiling is guiding personalized treatment strategy, and imaging technique that improves the accuracy of cancer detection is facilitating minimally invasive approach. The current status and future outlook of precision medicine will be discussed.

Liquid biopsy is a promising new diagnostic method with the potential to revolutionize the prevention, diagnosis, and treatment of solid tumors. However, several barriers need to be overcome for its clinical application. This session will present the latest technical developments and data on liquid biopsy in gastric cancer.

Developments in AI technology have enabled optimal decision-making in diagnostic imaging, endoscopy, and pathology. In recent years, AI-based surgical systems have also begun to be constructed. This session will clarify how AI is being used in the fields of gastric cancer, and its impact and challenges.

Access to oncologic treatment varies across countries due to the large differences in healthcare economics. This session will focus on the screening and treatment systems in low-income settings and discuss how to improve access to care.

Hereditary gastric cancer is specific subgroup of gastric cancer that requires multidisciplinary approaches, including screening, treatment, follow-up, and genomic counseling. This session will provide an overview of the optimal approaches for hereditary gastric cancer.

Socioeconomic inequalities in gastric cancer survival rates are observed due to differences in stage at diagnosis, gastric cancer subtypes, and access to and use of effective treatments. This session will discuss access to gastric cancer care in the context of the social background.

Developing patient advocacy is important for providing accurate information to patients and ensuring that their views are reflected in healthcare decision-making. This session will be a good opportunity to promote patient advocacy programs, services, and resources to oncologists.

Big data has been accumulated through the initiatives of various academic societies, and several important findings using that big data have been reported. In this session, we will discuss how to utilize big data in daily clinical practice.