Clinical efficacy of neoadjuvant chemotherapy combined with radical surgery for elderly patients with locally advanced gastric cancer
10.3760/cma.j.cn113855-20221026-00653
- VernacularTitle:新辅助化疗联合胃癌根治术治疗老年进展期胃癌患者的疗效分析
- Author:
Qi JIANG
1
;
Yuqiang DU
;
Chenggang ZHANG
;
Ming YANG
;
Jun FAN
;
Jianbo LYU
;
Gan MAO
;
Qian SHEN
;
Xiangyu ZENG
;
Weizhen LIU
;
Yuping YIN
;
Kaixiong TAO
;
Peng ZHANG
Author Information
1. 华中科技大学同济医学院附属协和医院胃肠外科 湖北省微创外科医学临床研究中心，武汉 430022
- Keywords:
Stomach neoplasms;
Neoadjuvant therapy;
Aged;
Post operative complications;
Prognosis
- From:
Chinese Journal of General Surgery
2023;38(4):263-268
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and feasibility of neoadjuvant chemotherapy (NACT) combined with radical surgery for elderly patients with locally advanced gastric cancer (LAGC).Methods:One hundred and fourty eight patients with LAGC after NACT and gastrectomy between 2012 and 2020 were retrospectively reviewed. They were divided into two groups: (1) <65 years old (111 cases) and (2) ≥65 years old (37 cases) and their clinicopathological and prognostic data were compared.Results:There was no significant difference between the two groups in the incidence of hematological complications such as anemia ( χ2=0.235, P=0.628), leukopenia ( χ2=0.613, P=0.434), neutropenia ( χ2=0.011, P=0.918) and thrombocytopenia ( χ2=0.253, P=0.615) and non-hematological complications such as nausea ( χ2=0.092, P=0.762), vomiting ( χ2=0.166, P=0.683), diarrhea ( χ2=0.015, P=0.902) and mucositis ( χ2=0.199, P=0.766) due to NACT. There were no statistical differences between the older patients and the younger in operation duration ( t=0.270, P=0.604), intraoperative bleeding ( t=1.140, P=0.250) and R 0 resection rate ( χ2=0.105, P=0.750). The incidence of postoperative complications was 25.2% and 37.8% in the younger patients and the olders ( χ2=2.172, P=0.141). Pleural effusion ( χ2=7.007, P=0.008) and pulmonary infection ( χ2=10.204, P=0.001) was significantly higher in the older patients than in the youngers. The 3-year progression-free survival rate ( t=0.494, P=0.482) and 3-year overall survival rate ( t=0.013, P=0.908) were comparable between the two groups. Conclusions:NACT combined with radical surgery is safe and effective in elderly patients with LAGC, except for higher perioperative pulmonary-related complications.
