Response to neoadjuvant chemotherapy and effects of tumor regression in gastric cancer

D'Ugo, D.; Persiani, R.; Rausei, S.; Biondi, A.; Vigorita, V.; Boccia, S.; Ricci, R.

doi:10.1016/j.ejso.2006.07.009

« Previous Next »European Journal of Surgical Oncology
Volume 32, Issue 10 , Pages 1105-1109, December 2006

Response to neoadjuvant chemotherapy and effects of tumor regression in gastric cancer

D. D'Ugo
- Division of Surgical Oncology, Hi-Tech Center for Education and Research in Biomedical Sciences, Catholic University – Località Tappino, 86100 Campobasso, Italy
R. Persiani
- Department of Surgery, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
- Corresponding author. Tel.: +39 6 3015 4849; fax: +39 6 3051 162.
S. Rausei
- Department of Surgery, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
A. Biondi
- Department of Surgery, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
V. Vigorita
- Department of Surgery, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy
S. Boccia
- Institute of Hygiene, Catholic University of Rome, Largo F. Vito 1, 00168 Rome, Italy
R. Ricci
- Division of Pathology, Catholic University of Rome, Largo A. Gemelli 8, 00168 Rome, Italy

Accepted 13 July 2006.

Abstract

Aims

Aim of this study is the evaluation of the effects induced by neoadjuvant chemotherapy (NACT) and its impact on survival on a series of locally advanced gastric carcinomas.

Methods

Downstaging was assessed comparing pre-treatment clinical and laparoscopic staging with post-operative pathologic staging on 30 consecutive patients who completed a 3-year follow-up. Tumor downstaging and the grade of pathologic response were included in a statistical correlation between tumor regression induced by NACT and 3-year survival.

Results

In this series tumor downstaging was obtained in 13 out of 30 patients. After the completion of 3-year follow-up, overall survival was >37.5months with an overall survival rate of 56.7%; this figure reached up to 70.8% in those cases who benefited from a R0-resection (24/30 patients: R0-resection rate 80.0%).

Conclusions

In this study the 3-year survival for locally advanced gastric cancer treated by NACT prior to “D2” surgical resection, compares favourably with historical series treated by surgery alone. Patients who obtained T-downstaging and subsequently benefited from a R0-resection had a definitely better chance of cure, according to a complete 3-year follow-up.

Keywords: Locally advanced gastric cancer, Laparoscopic staging, Neoadjuvant chemotherapy, Pathologic response, Tumor downstaging