Paolo Morgagni, surgeon, Morgagni-Pierantoni Hospital, Forlì, Italy

Biography

International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape : Bertinoro Workshop, November 2022.
Morgagni P, Bencivenga M, Carneiro F, Cascinu S, et al. Gastric Cancer. 2024 Jul;27(4):649-671. doi: 10.1007/s10120-024-01479-5.

Summary of presentation

Bertinoro International Workshop in 2022 had the purpose to conveying all the knowledge of many world leaders to find a consensus on the current expertise and evidence, in the treatment of stage IV gastric cancer. In particular, our aim was to better define the oligometastatic gastric cancer definition, comparing different view in the east and the west countries.  Ninetyseven experts from 16 countries were involved in the discussion and a paper was published on Gastric Cancer; consensus was found on many items, but several questions are still open, as that on how to stage regression, how to consider multiple site metastases, or peritoneal carcinosis.

RENAISSANCE phase III trial, as recently opened many questions on what it was just considered as established and 2 IGCA commissions are now ongoing to explore what kind of studies can be proposed on the stage IV gastric cancer, or specifically on the peritoneal site. Especially on this topic, consensus was found in Bertinoro considering this site as oligometastatic ,but not on citology and peritoneal carcinosis treatment. Recently several treatments had been proposed and it must be reconsidered.

Bertinoro most important insight is that oligometastatic patients can be treated and conversion surgery is possible, but new diagnostic tools and regression scores must be reconsidered and a more strict collaboration between surgeons and oncologists is necessary for medical support and time sequency decisions.

A second Bertinoro workshop will be held in the next future to improve consensus on what was not reached and  to propose new items as Immunotherpy and time for oncologic treatment