Pre-adjuvant chemotherapy leukocyte count may predict the outcome for advanced gastric cancer after radical resection

2014 ◽  
Vol 68 (2) ◽  
pp. 213-217 ◽  
Author(s):  
Dong Pei ◽  
Fang Zhu ◽  
Xiaofeng Chen ◽  
Jing Qian ◽  
Shaohua He ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Leukocyte Count ◽  
Radical Resection

scholarly journals Nomogram for predicting survival in advanced gastric cancer after neoadjuvant chemotherapy and radical surgery

2020 ◽  
Author(s):  
Yonghe Chen ◽  
Dan Liu ◽  
Jian Xiao ◽  
Jun Xiang ◽  
Aihong Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Cox Regression ◽  
Radical Surgery ◽  
Survival Rates ◽  
Radical Resection ◽  
R0 Resection ◽  
Clinical Parameters

Abstract BACKGROUND Neoadjuvant chemotherapy (NAC) with subsequent radical surgery has become a popular treatment modality for advanced gastric cancer (AGC) worldwide. However, the survival benefit is still controversial, and prognostic factors remain undetermined. AIM To identify clinical parameters that are associated with the survival of AGC patients after NAC and radical surgery and to establish a nomogram integrating multiple factors to predict survival. METHODS We reviewed the medical profiles of 215 AGC patients who received NAC and radical resection, and clinical parameters concerning NAC, surgery, pathological findings, and adjuvant chemotherapy were analyzed using a Cox regression model to determine their impact on survival. Based on these factors, a nomogram was developed and validated. RESULTS The overall 1-year and 3-year survival rates were 85.8% and 55.6%, respectively. Younger age (< 60 years old), increased examined lymph nodes (exLNs), successful R0 resection, achievement of pathological complete response (pCR), and acceptance of adjuvant chemotherapy were positive predictors of survival. The concordance statistic of the established nomogram was 0.785. The model showed an ideal calibration following internal bootstrap validation. CONCLUSION A nomogram predicting survival after NAC and surgery was established. Since this nomogram exhibited satisfactory and stable predictive power, it can be inferred that this it is a practical tool for predicting AGC patient survival after NAC and radical surgery.

Neoadjuvant chemoradiotherapy plus postoperative adjuvant XELOX chemotherapy versus postoperative adjuvant chemotherapy with XELOX regimen for local advanced gastric cancer-A randomized, controlled study

2021 ◽  
pp. 20201088
Author(s):  
Fuli Wang ◽  
Aizhong Qu ◽  
Yinping Sun ◽  
Jifeng Zhang ◽  
Benzun Wei ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Postoperative Complications ◽  
Advanced Gastric Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Regional Recurrence ◽  
R0 Resection ◽  
Resection Rate ◽  
Postoperative Adjuvant Chemotherapy ◽  
Local Advanced

Objective: The aim of this study was to compare the clinical efficacy of neoadjuvant chemoradiotherapy (NACRT) combined with postoperative adjuvant XELOX (Oxaliplatin +Capecitabine) chemotherapy and postoperative adjuvant chemotherapy (ACT) with XELOX for local advanced gastric cancer (LAGC). Methods: In this prospectively randomized trial, we investigated the effect of NACRT combined with postoperative ACT for LAGC. 60 patients were randomly divided into NACRT group and ACT group, with 30 patients in each group. Patients in NACRT group were given three-dimensional conformal radiotherapy (45 Gy/1.8 Gy/f) accompanied by synchronous XELOX of two cycles, followed by surgery, and then postoperative adjuvant XELOX chemotherapy of four cycles was performed. Patients in ACT group received surgery in advance, and then XELOX chemotherapy of six cycles was given. Results: The objective response rate of NACRT was 76.7%. The overall incidence of postoperative complications in NACRT group was not significantly different from that in ACT group (23.1% vs 30.0%, p = 0.560). The 1 year, 2 years, and 3 years progression-free survival (PFS）and overall survival (OS) in NACRT and ACT groups were 80.0% vs 56.7%, 73.3% vs 46.7%, 60.0% vs 33.3%, and 86.7% vs 80.0%, 76.7% vs 66.7%, 63.3% vs 50.0%, respectively. Patients in NACRT group showed a significantly higher R0 resection rate (84.6% vs 56.7%, p = 0.029),lower loco-regional recurrence rate (36.7% vs 11.5%, p = 0.039), longer PFS (p = 0.019) and freedom from locoregional progression(FFLP) (p = 0.004) than patients in ACT group, while there was no difference in OS (p = 0.215) and in toxicity incidence (p > 0.05). Conclusions: NACRT combined with postoperative adjuvant XELOX chemotherapy can improve R0 resection rate, reduce loco-regional recurrence, prolong PFS and FFLP without increasing the incidence of postoperative complications in patients with LAGC. Advances in knowledge: Compared with postoperative adjuvant chemotherapy, locally advanced gastric cancer patients may benefit from neoadjuvant chemoradiotherapy, and toxicity associated with chemoradiotherapy was tolerant and manageable.

Adjuvant chemotherapy enhances long-term survival of patients with advanced gastric cancer following curative resection

1990 ◽  
Vol 45 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Yoshihiko Maehara ◽  
Sunao Moriguchi ◽  
Yoshihisa Sakaguchi ◽  
Yasunori Emi ◽  
Shunji Kohnoe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Curative Resection ◽  
Term Survival ◽  
Long Term Survival

Evaluation of the effectiveness of adjuvant chemotherapy for locally advanced gastric cancer in real clinical practice

Pharmateca ◽  
2020 ◽  
Vol 7_2020 ◽  
pp. 41-45
Author(s):  
N.P. Belyak Belyak ◽  
R.V. Orlova Orlova ◽  
S.I. Kutukova Kutukova ◽  
N.V. Zhukova Zhukova ◽  
S.A. Borozdina Borozdina ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Locally Advanced Gastric Cancer ◽  
Real Clinical Practice

Combining cetuximab with FOLFOX regimen as the first-line therapy of KRAS wild-type advanced gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 157-157
Author(s):  
Yung-Sung Yeh
Keyword(s):  
Gastric Cancer ◽  
Adverse Events ◽  
Advanced Gastric Cancer ◽  
Large Scale ◽  
Direct Sequencing ◽  
Radical Resection ◽  
Wild Type ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

157 Background: Gastric cancer is one of the most common cancers worldwide with a high incidence in Asian countries, including Taiwan. For patients with recurrent or non-resectable advanced gastric cancer (AGC), chemotherapy or the combination of target and chemotherapy was chosen for therapy in AGC patients. We prospectively analyzed the safety and efficacy of cetuximab combined with FOLFOX4 as the first-line setting in patients with AGC. Methods: From January 2010 to January 2013, a total of 20 patients with histologically confirmed unresectable advanced/recurrent gastric cancer were enrolled into this study. Direct sequencing of KRAS mutation status was performed before the treatment. All patients received cetuximab 500 mg/m2every 2 weeks, and chemotherapy was administered with FOLFOX regimen of oxaliplatin at 85 mg/m2 plus leucovorin 200 mg/m2 on the first day of treatment, followed by 5-fluorouracil (5-FU) via a 24-hour continuous infusion of 1000 mg/ m2 5-FU on days 1-2 biweekly. Therapy was continued until disease progression or intolerable adverse events or receiving surgical resection. Results: All tumor tissues of 20 AGC patients were KRAS wild-type. With the median therapy of 6 cycles (4-8 cycles), clinical efficacy, according to RECIST criteria, showed an overall response rate of 55% (11/20), and 20% (4/20) of patients exhibited stable disease as well as 25% (5/20) who had progressive disease. Radical resection could be obtained in 30% (3/10) of unresectable patients as the neoadjuvant therapy. The median time to progress (TTP) was 8.3 months and the median overall survival (OS) was 12.2 months. The grade III-IV adverse events was observed in 4 of 20 (20%) patients, including 15% of neutropenia (3/20), 5% of skin rash (1/20), 10% of nausea and vomiting (2/20) as well as 15% of asthenia (3/20). Conclusions: Cetuximab combined with FOLFOX as the first-line therapy for KRAS wild-type AGC patients appears to have favorable efficacy and safety, and the possibility of conversion to radical resection. Grade 3-4 adverse events were relatively uncommon. Despite this preliminary favorable outcome; however, a long-term result and large scale clinical trial is mandatory to verify it.

scholarly journals Recent Advances in the Diagnosis, Staging, Treatment, and Prognosis of Advanced Gastric Cancer: A Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhi-da Chen ◽  
Peng-fei Zhang ◽  
Hong-qing Xi ◽  
Bo Wei ◽  
Lin Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Malignant Tumors ◽  
Treatment Options ◽  
Survival Rates ◽  
Radical Resection ◽  
Recent Advances ◽  
Drug Choice ◽  
Advanced Stages

Gastric cancer is one of the most common cause of cancer related deaths worldwide which results in malignant tumors in the digestive tract. The only radical treatment option available is surgical resection. Recently, the implementation of neoadjuvant chemotherapy resulted in 5-year survival rates of 95% for early gastric cancer. The main reason of treatment failure is that early diagnosis is minimal, with many patients presenting advanced stages. Hence, the greatest benefit of radical resection is missed. Consequently, the main therapeutic approach for advanced gastric cancer is combined surgery with neoadjuvant chemotherapy, targeted therapy, or immunotherapy. In this review, we will discuss the various treatment options for advanced gastric cancer. Clinical practice and clinical research is the most practical way of reaching new advents in terms of patients' characteristics, optimum drug choice, and better prognosis. With the recent advances in gastric cancer diagnosis, staging, treatment, and prognosis, we are evident that the improvement of survival in this patient population is just a matter of time.

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