J Korean Gastric Cancer Assoc.
2004 Mar;4(1):7-14.
The Role of Preoperative Chemotherapy in Patients with Inoperable Metastatic or Locally Advanced Gastric Cancer
- Affiliations
-
- 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. hkyang@plaza.snu.ac.kr
- 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 4Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
- 5Department of Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Abstract
- PURPOSE
The purpose of this study was to evaluate the treatment result of surgical resection after preoperative chemotherapy in inoperable gastric cancer patients.
MATERIALS AND METHODS
We analyzed 18 gastric cancer patients who underwent gastric resection after preoperative chemotherapy because they showed some clinical response to chemotherapy (15 with distant metastasis and 3 with locally advanced lesions). The mean postoperative follow-up period was 15.3+/-15.5 (1~56) months.
RESULTS
In 15 patients with distant metastasis, 2 (13.3%) showed complete response (CR), 10 (66.7%) partial response (PR), 2 (13.3%) stable disease (SD), and 1 (6.7%) progressive disease (PD). The clinical response rate was 80.0%. Five subtotal gastrectomies, 4 total gastrectomies, and 6 extended total gastrectomies were performed. Two cases of CR were alive without recurrence for 4 and 26 months, respectively. Mean survival period in PR case was 37.7 months, but 2 cases of SD and 1 case of PD died after 11.7, 17.9, and 0.9 months, respectively. Postoperative survival was significantly associated with the response to chemotherapy (P<0.01). The mean survival period of the 10 patients with a complete resection was 44.1 months, which was significantly better than that of the 5 patients with an incomplete resection (9.8 months, P=0.03). Among 3 patients with locally advanced gastric cancer, 2 cases showed PR to chemotherapy, and complete resection was possible only by gastrectomy for those patients.
CONCLUSION
In some selected cases, surgical resection was achievable after preoperative chemotherapy for patients with inoperable metastatic or locally advanced gastric cancer.
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