Pathologic and Oncologic Outcomes in Locally Advanced Gastric Cancer with Neoadjuvant Chemotherapy or Chemoradiotherapy.
10.3349/ymj.2013.54.4.888
- Author:
Ji Yeong AN
1
;
Hyoung Il KIM
;
Jae Ho CHEONG
;
Woo Jin HYUNG
;
Choong Bae KIM
;
Sung Hoon NOH
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. sunghoonn@yuhs.ac
- Publication Type:Original Article ; Clinical Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Gastric cancer;
neoadjuvant chemotherapy;
neoadjuvant chemoradiotherapy;
gastrectomy;
pathologic response;
prognosis
- MeSH:
Aged;
Chemoradiotherapy/*methods;
Disease-Free Survival;
Female;
Gastrectomy;
Humans;
Male;
Middle Aged;
Neoadjuvant Therapy;
Neoplasm Recurrence, Local/pathology;
Stomach Neoplasms/*drug therapy/mortality/pathology/*radiotherapy/surgery;
Treatment Outcome;
Tumor Markers, Biological
- From:Yonsei Medical Journal
2013;54(4):888-894
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Although neoadjuvant therapy has been accepted as a treatment option in locally-advanced gastric cancer, its prognostic value has been difficult to evaluate. MATERIALS AND METHODS: Seventy-four gastric cancer patients who underwent gastrectomy after neoadjuvant treatment were divided into two groups according to the pathologic response: favorable (ypT0) and others (ypT1-4). The clinicopathologic characteristics, predictive factors for pathologic response, and oncologic outcome were evaluated. RESULTS: Eleven patients (14.8%) demonstrated ypT0 and the remaining 63 patients (85.2%) were ypT1-4. Chemoradiotherapy (CCRTx) rather than chemotherapy (CTx) was the only predictive factor for a favorable pathologic response. Chemotherapeutic factors and tumor marker levels did not predict pathologic response. The 1-, 2-, and 3-year disease-free survivals were 83.4%, 70%, and 52.2%. The 1-, 3-, 5-year overall survivals were 88.5%, 67.5%, and 51.2%, respectively. Although a complete pathologic response (ypT0N0M0) was achieved in 7 patients, 28.6% of them demonstrated recurrence of the tumor within 6 months after curative surgery. CONCLUSION: CCRTx rather than CTx appears to be more effective for achieving good pathologic response. Although favorable pathologic response has been achieved after neoadjuvant treatment, the survival benefit remains controversial.
