Late term renal complications related to chemoradiotherapy in patients with gastric cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15033-15033
Author(s):  
A. Mayadagli ◽  
O. O. Seseogullari ◽  
C. Gemici ◽  
A. Ozkan ◽  
C. Parlak ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Renal Damage ◽  
Statistical Significance ◽  
Combined Treatment ◽  
Subtotal Gastrectomy ◽  
Renal Scintigraphy ◽  
Normal Range ◽  
Curative Surgery ◽  
Renal Complications

15033 Background: The aim of this study is to evaluate late term renal complications of the combined treatment with chemoradiotherapy, according to the scheme of McDonald et al, in patients diagnosed with gastric cancer, after radical curative surgery. Methods: Totally 44 patients who administered to our clinic between years 2003 and 2004, with the diagnosis of gastric cancer, and with the age-adjusted creatinine clearance test (CCT) results within normal range, were enrolled into the study. Surgical procedure was subtotal gastrectomy in 34 patients (63,6%), and total gastrectomy in 16 patients (36,4%). Total 4600 cGy radiotherapy was administered to all patients through parallel-opposed AP-PA fields in 23 fractions concomitant with chemotherapy according to the scheme of McDonald et al. One year after the completion of the treatment, a technetium 99-m renal scintigraphy (DMSA) and CCT were performed to all patients whose renal functions were within normal limits. Results: Median age in the study was 52 (22–78). 34 patients (77,3%) were male and 10 (22,7%) were female. TNM stages were stage II in 15 (34,1%), IIIA in 21 (47,7%), IIIB in 4 (9,1%), and IV in 4 cases (9,1%). CCT measured 1 year after the treatment was low in 13 patients (29,6%), and within normal range in 31 patients (70,4%). Renal scintigraphy revealed damage at one pole in 32 patients (72,7%), damage at bilateral renal poles in 8 patients (18,3%), and it was normal in 4 patients (9%). Renal damage was higher in left kidneys than right kidneys (89,9% vs. 15,4%). There was a correlation between CCT values and scintigraphical findings. Damage in bilateral renal poles was higher in cases with low CCT than in cases with normal values (85,7% vs. 15,4). In general, there were no statistically significant relationship between late term renal complications and sex, and grade III treatment-related gastrointestinal toxicity. However, the relationships with age, extent of surgery reached statistical significance (p=0.009, and =0.006). Renal damage was notably higher in older patients, and in patients who underwent total gastrectomy. Conclusions: Since postoperative chemoradiotherapy is a novel modality for the treatment of gastric cancer, more studies are required in order to evaluate chronic toxicities. No significant financial relationships to disclose.

scholarly journals Erratum: Advantages of Distal Subtotal Gastrectomy Over Total Gastrectomy in the Quality of Life of Long-Term Gastric Cancer Survivors

2020 ◽  
Vol 20 (3) ◽  
pp. 344
Author(s):  
Oh Kyoung Kwon ◽  
Byunghyuk Yu ◽  
Ki Bum Park ◽  
Ji Yeon Park ◽  
Seung Soo Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Cancer Survivors ◽  
Total Gastrectomy ◽  
Subtotal Gastrectomy

NESC multicenter phase II trial in the preoperative treatment of gastric adenocarcinoma with chemotherapy (docetaxel-cisplatin-5FU + lenograstim) followed by chemoradiation (RTCT) based 5FU and oxaliplatin and surgery.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 95-95
Author(s):  
Laurent Mineur ◽  
Gael Deplanque ◽  
Francoise Desseigne ◽  
Laurence Moureau-Zabotto ◽  
Olivier Boulat ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Continuous Infusion ◽  
Total Gastrectomy ◽  
Gastric Adenocarcinoma ◽  
Response Rate ◽  
Subtotal Gastrectomy ◽  
High Response Rate ◽  
Phase Iii ◽  
R0 Resection ◽  
Preoperative Treatment

95 Background: Perioperative chemotherapy is a standard treatment. The combination of Docetaxel- cddp-5FU(DCF) is a treatment in metastatic gastric cancer with high response rate. Preoperative RTCT is expected to increase the rate of curative resections and complete histological response. We investigate the efficacy of an optimal chemotherapy with DCF + lenograstim then preoperative RTCT with oxaliplatin - 5FU in gastric adk. Methods: Between 2009 and 2014, 33 patients with gastric adenocarcinoma(adk) were included. Inclusion criteria adk of stomach, cardia, Siewert II, III, according to staging classification T2bT3T4anyNM0 optional laparoscopy. Treatment consisted of 2 cycles docetaxel 75 mg/m2 I.V. day 1, cddp 75 mg/ m2 I.V. day 1, 5-FU 750 mg/m2 continuous infusion for 120 h, every 3 weeks and lenograstim followed by RTCT delivered in 25 daily fractions of 1.8 Gy in 5 weeks with 5Fu 250mg/m2 continuous infusion per day on days 1 to 35 and oxaliplatin 85mg/m2 day 1-14-28. Surgery was performed 4-6 weeks after RTCT. The primary endpoints were pathological response rate and secondary PFS, overall survival, morbidity and post operative mortality, toxicity. Results: 33 patients were included, 1patient progressive disease(PD) after 2 cycles of DCF, 32 patients received RTCT and 2 patients PD after RTCT, 1 patient refused surgery. 29 patients were operated and 3 non resected (peritoneal metastasis). 26 patients underwent surgery after RTCT (total gastrectomy n = 12, total gastrectomy and diaphragm surgery n = 1 lewis santy n = 11, subtotal gastrectomy n = 1, Enlarged gastrectomy transverse colectomy and partial pancreatic n = 1 D1 (n = 5) and D2 (n = 21) R0 resection rate was n = 26/26. Postoperative morbidity (n = 12) and mortality (n = 2), histology mean nods examined and involved respectively 16 and 2,5. pT0pN0 23% pT1pN0 19% pTpN2N3 20% others 38%. < 10% residual tumor 27% histologic complete response 23%. Conclusions: Promising results from trials involving preoperative chemoradiation followed by surgery in gastric cancer need to be further evaluated in a Phase III and compared with perioperative CT. Clinical trial information: NCT01565109.

scholarly journals Advantages of Distal Subtotal Gastrectomy over Total Gastrectomy in the Quality of Life of Long-Term Gastric Cancer Survivors

2020 ◽  
Vol 20 (2) ◽  
pp. 176
Author(s):  
Oh Kyoung Kwon ◽  
Byunghyuk Yu ◽  
Ki Bum Park ◽  
Ji Yeon Park ◽  
Seung Soo Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Cancer Survivors ◽  
Total Gastrectomy ◽  
Subtotal Gastrectomy

scholarly journals ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER?

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
Nelson Adami ANDREOLLO ◽  
Eric DRIZLIONOKS ◽  
Valdir TERCIOTI-JUNIOR ◽  
João de Souza COELHO-NETO ◽  
José Antonio Possato FERRER ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
Adjuvant Treatment ◽  
Subtotal Gastrectomy ◽  
Adjuvant Chemoradiotherapy ◽  
Curative Intent ◽  
Number Of Patients ◽  
Significant Difference

ABSTRACT Background: The treatment of advanced gastric cancer with curative intent is essentially surgical and chemoradiotherapy is indicated as neo or adjuvant to control the disease and prolong survival. Aim: To assess the survival of patients undergoing subtotal or total gastrectomy with D2 lymphadenectomy followed by adjuvant chemoradiotherapy. Methods: Were retrospectively analyzed 87 gastrectomized patients with advanced gastric adenocarcinoma, considered stages IB to IIIC and submitted to adjuvant chemoradiotherapy (protocol INT 0116). Tumors of the esophagogastric junction, with peritoneal implants, distant metastases, and those that had a compromised surgical margin or early death after surgery were excluded. They were separated according to the extention of the gastrectomy and analyzed for tumor site and histopathology, lymph node invasion, staging, morbidity and survival. Results: The total number of patients who successfully completed the adjuvant treatment was 45 (51.7%). Those who started treatment and discontinued due to toxicity, tumor-related worsening, or loss of follow-up were 10 (11.5%) and reported as incomplete adjuvant. The number of patients who refused or did not start adjuvant treatment was 33 (48.3%). Subtotal gastrectomy was indicated in 60 (68.9%) and total in 27 (31.1%) and this had a shorter survival. The mean resected lymph nodes was 30.8. Staging and number of lymph nodes affected were predictors of worse survival and the more advanced the tumor. Patients undergoing adjuvant therapy with complete chemoradiotherapy showed a longer survival when compared to those who did it incompletely or underwent exclusive surgery. On the other hand, comparing the T4b (IIIB + IIIC) staging patients who had complete adjuvance with those who underwent the exclusive operation or who did not complete the adjuvant, there was a significant difference in survival. Conclusion: Adjuvant chemoradiotherapy presents survival gain for T4b patients undergoing surgical treatment with curative intent.

The prognostic significance of Cerb-B2 determination in gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14713-e14713
Author(s):  
Antonio CALDEIRA Fradique
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Statistical Significance ◽  
Prognostic Significance ◽  
Subtotal Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Tumor Aggressiveness ◽  
Resectable Gastric Cancer ◽  
Node Metastases

e14713 Background: The Cerb-B2/HER2 marker, is a glycoprotein encoded by the ERBB2 oncogene, belongs to the family of epidermal growth factor receptors (EGFR), which has based its application on tests of new therapeutic modalities (target therapy). Apart from this interest has been invoked its value as a marker of tumor aggressiveness, due to his role as a regulator of cell proliferation and migration and consequent invasiveness and metastization. However, the results as to the meaning prognosis of this molecular marker are controversial and with variations depending on the geographical zone. Results: From a total of 50 pts. with advanced resectable gastric cancer that underwent surgery with D2 lymphadenectomy, 38 pts. had a total gastrectomy, and 12 pts. had subtotal gastrectomy. A mean of 35.7 lymph nodes/pt were resected at surgery. In 68% of pts. positive lymph node metastases were present. Tumor HER2-neu overexpression was observed in 16 pts (32%), several other parameters of tumor aggressiveness were also present, without any statistical significance or relevance. Methods: To determine if the Cerb-B2 played a prognostic role in gastric cancer, a total of 50 pts. with advanced resectable gastric cancer, were submitted to gastrectomy with D2 lymphadenectomy. In all cases assessment for tumor HER2-neu overexpression was performed using immunohistochemistry (IHC). FISH was used as a confirmation method in tumors with 2+ expression by IHC. A correlation was made between the tumor HER2-neu expression and the following parameters: tumor location, size, histological type, depth of invasion, lymph node metastases and clinical staging. Results: From a total of 50 pts. with advanced resectable gastric cancer that underwent surgery with D2 lymphadenectomy, 38 pts. had a total gastrectomy, and 12 pts. had subtotal gastrectomy. A mean of 35.7 lymph nodes/pt were resected at surgery. In 68% of pts. positive lymph node metastases were present.Tumor HER2-neu overexpression was observed in 16 pts (32%), several other parameters of tumor aggressiveness were also present, without any statistical significance or relevance. Conclusions: The determination of Cerb-B2 / HER2 expression has not shown prognostic significance in this study.

Sign in / Sign up

Export Citation Format

Share Document