Morbidity and mortality of laparoscopic D2+CME versus conventional D2 procedure for locally advanced gastric adenocarcinoma (NCT01978444)

2020 ◽  
Vol 46 (2) ◽  
pp. e26
Author(s):  
Daxing Xie ◽  
Jianping Gong
Keyword(s):  
Gastric Adenocarcinoma ◽  
Locally Advanced ◽  
Morbidity And Mortality ◽  
Advanced Gastric Adenocarcinoma

Locally Advanced Gastric Adenocarcinoma with Impressive Response to Hemostatic Radiation: the Possible Role of p53 Status and Eosinophilic Infiltrate

2020 ◽  
Author(s):  
Abraão Ferreira Lopes Dornellas ◽  
Marcus Fernando Kodama Pertille Ramos ◽  
Marina Alessandra Pereira ◽  
Leonardo Cardili ◽  
Andre Roncon Dias ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Locally Advanced ◽  
Eosinophilic Infiltrate ◽  
Advanced Gastric Adenocarcinoma ◽  
P53 Status

A phase II study of preoperative docetaxel, cisplatin, and capecitabine in patients with gastric carcinoma.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 89-89 ◽  
Author(s):  
Pei-Jye Voon ◽  
Mu-Yar Soe ◽  
Ying Kiat Zee ◽  
Benjamin Chuah ◽  
Robert S. C. Lim ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Phase Ii ◽  
Locally Advanced ◽  
Postoperative Mortality ◽  
Complete Response ◽  
Pathological Response ◽  
Perioperative Chemotherapy ◽  
Advanced Gastric Adenocarcinoma ◽  
Grade 3 ◽  
Dose Modifications

89 Background: Perioperative chemotherapy has been shown to improve outcomes among patients with locally advanced gastric adenocarcinoma. As docetaxel (D), cisplatin (C), and capecitabine (X) are active agents in gastric adenocarcinoma, we conducted a phase II trial to assess the efficacy and tolerability of preoperative DCX in patients with gastric adenocarcinoma. Methods: We enrolled patients with locally advanced gastric adenocarcinoma (clinical T3/4 or N positive) to preoperative DCX repeated every 21 days for three cycles, followed by surgery. The first cohort of 10 patients received docetaxel 35 mg/m2, cisplatin 35mg/m2 on days 1 and 8, with capecitabine 750 mg/m2 twice daily from day 1 to day 14. A subsequent cohort of another 11 patients had dose modifications for docetaxel and cisplatin, both to 30mg/ m2 on days 1 and 8. Results: Twenty-one patients were recruited. Median age was 61 years. Seventy-one percent of patients completed a total of 3 cycles of planned chemotherapy. Fourteen patients have successfully undergone surgery. R0 resection rate was 88%. Pathological complete response (pCR) and near complete response (pnCR) were both 17%. Preoperative radiological assessment showed a partial response rate of 65% after 2 cycles of treatment. Good pathological response (pCR and pnCR) was associated with better event-free survival (26 months vs 12 months, p=0.031). Common grade 3/4 toxicities were diarrhea (38%), neutropenia (30%), stomatitis (14%) and hypokalemia (14%). However, the diarrhea rate was reduced to 15% with dose modifications as mentioned above after 50% of the first cohort of 10 patients developed grade 3/4 diarrhea during the first cycle of chemotherapy. Febrile neutropenia rate was 14%. There was one treatment related death before surgery but no postoperative mortality. Conclusions: Preoperative DCX is highly active with modest toxicity in locally advanced gastric adenocarcinoma. DCX represents an attractive alternative regimen without the need for protracted infusional drug in perioperative chemotherapy for patients with locally advanced gastric adenocarcinoma. Good pathological response is associated with better outcome.

Trends in utilization of chemotherapy and radiation for resectable gastric adenocarcinoma: An NCDB analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 163-163
Author(s):  
Benjamin Mitchell Motz ◽  
Patrick Daniel Lorimer ◽  
Kendall K Walsh ◽  
I'sis N Perry ◽  
Yimei Han ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Adjunctive Therapy ◽  
Locally Advanced ◽  
Multivariable Analysis ◽  
Clinical Staging ◽  
Sequencing Data ◽  
Chi Square ◽  
Institutional Practices ◽  
Factors Affecting ◽  
Advanced Gastric Adenocarcinoma

163 Background: Locally advanced gastric adenocarcinoma (GACa) is optimally treated with a combination of surgery, chemotherapy (CHEMO) and radiation (RT). Utilization of therapies can vary with institutional practices. Methods: The NCDB was queried for pts with GACa who had RO resection (2006-2012). Pts with metastatic disease, incomplete pathologic staging, and incomplete CHEMO or RT sequencing data were excluded. Pts were divided into groups by treatment regimen: G1: perioperative CHEMO; G2: adjuvant CHEMO±RT; G3: neoadjuvant CHEMORT; G4: other adjunctive regimens; G5: surgery only. Pts who received neoadjuvant therapy were staged using clinical TNM; those who did not or had incomplete clinical staging were staged using pathologic TNM. 3 subsets were created: LOCAL: T0-2N0, LOCALLY ADV: T3-4N0, REGIONAL: N+. Chi-square, univariate, multivariable with stepwise selection, and Cochran-Armitage time trend analyses were performed. Results: N = 12946: G1 = 1099, G2 = 4771, G3 = 180, G4 = 244 and G5 = 6652. The percentage of pts receiving adjunctive therapy was determined for each subset: LOCAL = 17.2%, LOCALLY ADV = 59.8%, and REGIONAL = 66.0%. Use of adjunctive therapy increased from 2006: 44% to 2012: 53% (p < 0.01). Use of perioperative CHEMO increased from 2006: 4% to 2012: 18% (p < 0.01). Factors affecting use of adjunctive therapy on multivariable analysis are: age (p < 0.01), race (p < 0.01), income (p < 0.01), insurance (p < 0.01), comorbidity score (p < 0.01), and facility volume (p = 0.01). Conclusions: Though utilization of adjunctive therapy is increasing, a large proportion of pts with resectable GACa do not receive recommended adjunctive therapy. This study highlights disparities in utilization of optimal multimodality care. National efforts to expand access to care are necessary to improve outcomes in resectable GACa. [Table: see text]

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