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KMID : 0914820040040010007
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Journal of the Korean Gastric Cancer Association
2004 Volume.4 No. 1 p.7 ~ p.14
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The Role of Preoperative Chemotherapy in Patients with Inoperable Metastatic or Locally Advanced Gastric Cancer
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Chung Yoo-Seung
Park Do-Joong
Lee Hyuk-Joon
Kim Se-Hyung
Han Joon-Koo
Kim Tae-You
Bang Young-Jue
Heo Dae-Seok
Kim Noe-Kyeong
Kim Woo-Ho
Yang Han-Kwang
Lee Kuhn-Uk
Choi Kook-Jin
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Abstract
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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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KEYWORD
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Gastric cancer, Preoperative chemotherapy, Prognosis
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