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KMID : 0360319920240040541
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Journal of Korean Cancer Research Association
1992 Volume.24 No. 4 p.541 ~ p.548
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Pathological Observations in Locally Advanced Gastric Carcinomas after Preoperative Chemotherapy
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조경자
장자준/하창원/고재수/이종인/최동욱/강윤구
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Abstract
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Neoadjuvant chemotherapy on locally advanced unresectable gastric cancers is recently considered to be benificial to downstaging of tumors and better chance of curative resection. This study was aimed to describe morphologic alterations in
gastric
adenocarcinomas after chemotherapy and discuss their clinical significances. Thirty two cases to advanced gastric carcinomas which were surgically resected after 2-3 cycles of chemotherapy with C-DDP/VP-16/5-FU(PEF) were reviewed. The patients
were
initially diagnosed by endoscopic biopsies, and staged through radiologic studies as unresectable cases without distant metastasis. On microscopic examination, 19 cases(59%) revealed major pathologic alterations. Four cases showed pathologic
complete
remission, histologically resembling healed or active peptic ulcers. The most common histologic changes, observed in 14 cases, were dense fibroses with ad decrease in tumor cellularity, which were more frequent in poorly differentiated than in
moderately differentiated tubular adenocarcinoma. The changes were also observed in metastatic tumors in regional lymph nodes of 6 cases. One case of mucinous carcinoma was totally composed of acellular mucin pools both in primary and metastatic
lesions. Twenty one patients(68%) revealed T and /or N downstaging, more-frequently with poorly differentiated adenocarcinomas. But the presence of pathologic alterations and of downstaging effect did not correlate each other. Accurate assessment
of
chemotherapy response is dependent on careful clinical studies and thorough histological examination of the resected specimens. Our data suggest that PEF neoadjuvant chemotherapy for locally advanced gastric carcinoma is feasible, and additional
studies
to achieve more frequent pathologic response may be warranted.
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KEYWORD
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