Neoadjuvant Chemotherapy in Local Advanced Gastric Cancer

Document Type : Original Article

10.22118/jjo.2015.49185

Abstract

dence in western countries. Surgery alone has not been effective for treatment of locoregional gastric cancer be-cause of the low rate of curative resection and high incidence of local recurrence and distant metastases. Our aim was to determine the resectability of tumor after neoadjuvant chemotherapy. Fourteen patients with clinical stage III gastric adenocarcinoma that initially seemed to be unresectable by laparoscopy were treated with three cycles of cisplatin 60 mg/m2, 5-Fluorouracil 750 mg/m2 and Epirubicin 50 mg/m2 three weeks before surgery. : Thirteen patients were operable for surgery after neoadjuvant chemotherapy (Pvalue= 0.001), while one patient was not operable due to developing distal metastasis. Twelve (85.85%) patients were resectable with patho-logic report of R 0 and, one (7.15%) patient was reported R1, (Pvalue= 0.001). A total number of 97 patients, with mediastinal involvement by primary masses, were contributed in this study. Biopsy was taken through the several ways. The numbers of 52(53.60%) “Lymphoma” and 45 (46.40%) cases with other pathologic results were dominantly detected with “tuberculosis”. Two cases of lymphoma was found in two referred cases with MMs <10 years and the overall incidence of involvement was begun from first to fifth dec-ades with the peak in third to fourth decades along with mostly anterior mediastinal locations. This study shows that neoadjuvant chemotherapy improves operability and resectability of the tumor in patients with local advanced gastric adenocarcinoma.

Keywords

References

1. Parkin DM, Bray F. Evaluation of data quality in the can-cer registry: principles and methods Part II. Complete-ness. . 2009;(5):756-64.
2. Center for disease control & Prevention Non communi-cable Deputy, cancer center. Iranian Annual of Na-tionalancer Registration Report. March 2007; XXVII.
3. Babai M, Mousavi S, Toussy J. Cancer occurrence in old age: Results of a population based cancer registrya in Semnan, I ran. . 2006;(2):191-4.
4. Sadjadi A, Malekzadeh R, Derakhshan MH, Sepehr A, Nouraie M, Sotoudeh M, Yazdanb od A, Shokoohi B, Mashayekhi A, Arshi S, Majidpour A, Babaei M, Mosavi A, Mohagheghi MA, Alimohammadian M. Cancer occurrence in Ardabil: results of a population-based cancer registry from I ran. . 2003;;107(1):113-8.
5. Mohagheghi MA, Mosavi-Jarrahi A, Malekzadeh R, Parkin M. Cancer incidence in Tehran metropolis: the first re-port from the Tehran Population-based Cancer Registry, 1998-2001. . 2009;(1):15-23.
6. Smith JL, Luke RE, Douglass HO: Adjuvant therapy of stomach cancer: clinical trial results: In: Wanebo HJ (ed). Surgery for Gastroin testinal Cancer. Philadelphia: , 1997:347-353.
7. Dolores Gallard o-Rin co´n, Luis F. On˜a te-Ocan˜a, and Germa´n Calderillo-Ruiz. Neoadjuvant Chemotherapy with P-ELF (Cisplatin, Etoposide, Leucovorin, 5-Fluorou racil) Followed by Radical Resection in Patients with Ini-tially Unresectable Gastric Adenocarcinoma: A Phase II Stud y. 2000;7(1):45–50.
8. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Ni colson M, Sca rffe JH, Lofts FJ, Falk SJ, I veson TJ, Smith DB, Langley RE, Verma M, Weeden S, Chua YJ, MAGI C Trial Participants. Perioperative chemo-therapy versus surgery alone for resectable gastroesop hageal cancer. . 2006;(1):11-20.
9. Kelsen D, Karpeh M, Schwartz G, Gerdes H, Lightdale C, Botet J, Lauers G, Klimstra D, Huang Y, Saltz L, Quan V, and Brennan M. Neoadjuvant therapy of high-risk gastric cancer: a phase II trial of preoperative FAMTX and post-operative intraperitoneal fluorouracil-cisplatin plus in-travenous fluorouracil. , 14(6):1818-28.
10. Cascinu S, Scartozzi M, Labianca R, et al. High Curative Resection Ratewith Weekly, 5 -fluorouracil, epidoxorubi-cin, 6S-Leucovorin, Glutathione, and Filgrastim in Pa-tients with Locally Advanced, Unresectable Gastric Can-cer: A Report From the Italian Group for the Study of Di-gestive Tract Cancer (GI SCAD). 2004;:1551-1525.
11. Schuhmacher CP, Fink U, Becker K, et al. Neoadjuvant Therapy for Patients with Locally Advanced Gastric Car-cinoma with Etoposide, doxorubicin, and cisplatinum. Closing Results after 5 Years of Follow-up. 2001;:918-927.
12. John E. Niederhuber, Neoadjuvant therapy. . 1999;(3):309-312.
13. Dolores Gallardo -Rinco´n, Luis F. On˜a te -Ocan ˜a, Germa´n Calderillo -Ruiz. Neoadjuvant Chemo therapy With P-ELF (Cisplatin, Etoposide , Leu covorin, 5-Fluorouracil) Followed by Radical Resection in Patients With Initially Unresectable Gastric Adenocarcinoma: A Phase II Stud y. . 2000, (1):45–50.
14. Satoru N, Atsushi NM, Hiroshi Y. Neoadjuvant chemo-therapy for Patients with Positive cytology from ad-vanced gastric Cancer. 2006;:(12);1774-1776.
15. Scuhmacher CP, Fink U, Becker K, Busch R, Dittler HJ, Mueller J, Siewert JR. Neoadjuvant therapy for patients
with locally advanced gastric carcinoma with etoposide, doxorubicin and cisplatin. . 2001;:918-27.
16. Beckeretal K. Neoadjuvant chemo therapy for patients with locally advanced gastric carcinoma. . 1999; :1484-9.
17. D'Ugo D, Persiani R, Rausei S, Biondi A, Vigori ta V, Bocia S et al. Response to neoadjuvant chemo therapy and ef-fects of tumor regression in gastric cancer. . 2006;(10):1105-9.
18. Crookes P, Leichman CG, Leichman L, et al. Systemic chemotherapy for gastric carcinoma followed by post-operative in traperitoneal therapy: a final report. . 1997;:1767-1775.
19. Swisher SG, Holmes EC, Hunt KK, Doty JE, Zinner MJ, Mc Fadden DW. The role of neoadjuvant therapy in surgical-ly resectable esophageal cancer. . 1996; :819-824.
20. Nakata B, Chung KH, Muguruma K, et al. Changes in tu-mor marker levels as a predictor of chemo therapeutic effect in patients with gastric carcinoma. . 1998; : 19-24. Jundishapur J Oncol. 2015 24 March; 1(1):21-24
21. Ai-Wen Wu, Jia-Fu Ji. Neoadjuvant chemotherapy for lo-
cally advanced gastric cancer: With or without radiation. . 2012; (2):27–31.

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History

  • Receive Date: 10 June 2014
  • Revise Date: 21 May 2014
  • Accept Date: 09 July 2014

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