EVALUATE PRELIMINARY RESULTS OF SURGERY FOR GASTRIC CANCER COMBINATED ADJUVANT CHEMOTHERAPY

2014 ◽  
pp. 111-119
Author(s):  
Quang Bo Nguyen ◽  
Manh Ha Le ◽  
Nhu Hiep Pham ◽  
Loc Le
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Postoperative Mortality ◽  
Stage Iv ◽  
Life Time ◽  
Disease Stage ◽  
Mortality And Morbidity ◽  
Preliminary Results ◽  
Number Of Patients ◽  
Results Of Surgery

Purpose: To review some characteristics of patients and evaluate preliminary results of adjuvant chemotherapy for patients with resected gastric cancer. Objectives and Methods:The study was conducted on 30 patients with gastric cancer (male/female = 20/10) treated by adjuvant chemotherapy after gastrectomy at the Digestive Surgical Depatment at Hue Central Hospital from January. 2011 to May. 2012. We noted their clinical and paraclinical signs and studied the preliminary results of adjuvant chemotherapy after gastrectomy for gastric cancer. Results: The male/female = 2/1, The common group of age is 41-60, accounting for 63,33%. The primary tumor were found mostly at antrum and pylorus (66,67%).The postoperative mortality and morbidity common rates were 0% and 3,33%. Almost patients treated by adjuvant chemotherapy from 4-8 weeks after gastrectomy (73,33%). Fatigue is the most common toxicity of chemotherapy with 33,33% and alopecia was 26,67%. The follow-up time is about 11 months (rank 6-15 months). The life time expectancy of all 30 patients by stages disease: Stage II: 100%, stage III: 94,17% and stage IV: 16,67%. Conclusion: We review general characteristics of patients, and evaluate the results of surgery, quality of life after surgery combine with supportive care. Number of patients with total points within the 8-10 points by Spitzer index from 70% to 80% after the second re-examination. Most of chemotherapy toxicity is tolerable. However, this study needs to be carry out in the longer time, with larger number of patients. Key words: gastric cancer, chemotherapy

Adjuvant chemotherapy in stage III gastric cancer: Preliminary results

1993 ◽  
Vol 29 ◽  
pp. S102
Author(s):  
L. Cirera ◽  
T. Cardona ◽  
E. Batiste ◽  
A. Arcusa ◽  
I. Tusquets ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Stage Iii ◽  
Preliminary Results

Prognostic Indicators in Stage IV Surgically Treated Gastric Cancer Patients: A Retrospective Multi-Institutional Study

2018 ◽  
Vol 36 (4) ◽  
pp. 331-339
Author(s):  
Alberto Biondi ◽  
Domenico D’Ugo ◽  
Ferdinando Cananzi ◽  
Stefano Rausei ◽  
Federico Sicoli ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Residual Disease ◽  
Stage Iv ◽  
Long Term Results ◽  
Stage Iv Gastric Cancer ◽  
Short And Long Term ◽  
Gastric Cancer Patients

Introduction: The role of gastric resection in treating metastatic gastric adenocarcinoma is controversial. In the present study, we reviewed the short- and long-term outcomes of stage IV patients undergoing surgery. Methods: A retrospective review was conducted that assessed patients undergoing elective surgery for incurable gastric carcinoma. Short- and long-term results were evaluated. Results: A total of 122 stage IV gastric cancer patients were assessed. Postoperative mortality was 5.7%, and the overall rate of complications was 35.2%. The overall survival rate at 1 and 3 years was 58 and 19% respectively; the median survival was 14 months. Improved survival was observed for the factors age less than 60 years (p = 0.015), site of metastases (p = 0.022), extended lymph node dissection (p = 0.044), absence of residual disease after surgery (p = 0.001), and administration of adjuvant chemotherapy (p = 0.016). Multivariate analysis showed that residual disease and adjuvant chemotherapy were independent prognostic factors. Conclusions: The results of this study suggest that surgery combined with systemic chemotherapy in selected patients with stage IV gastric cancer can improve survival.

Long-term results of surgical treatment of gastric cancer

1986 ◽  
Vol 67 (2) ◽  
pp. 104-106
Author(s):  
A. S. Abdullin ◽  
F. Sh. Akhmetzyanov ◽  
A. A. Samigullin ◽  
Z. N. Shemeunova ◽  
V. A. Arinin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Stomach Cancer ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Disease Stage ◽  
Long Term Results ◽  
Long Term Outcomes

We analyzed long-term outcomes of the treatment of 217 patients (men - 126, women - 91), who underwent radical operations for stomach cancer in the period of 1972 till 1976. 14 patients were under 39, 52 - from 40 to 49, 50 to 59 - 52, 60 to 69 - 80, over 70 years old - 19. The youngest patient was 28 years old and the oldest - 76 years old. Most patients (185) were operated on at stage III of the disease, stage II was diagnosed in 27 patients, and stage IV - in 5 patients.

Investigatory study of biomarkers for gastric cancer based on a cDNA bank.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4070-4070
Author(s):  
Takashi Oshima ◽  
Toshio Imada ◽  
Chikara Kunisaki ◽  
Takaki Yoshikawa ◽  
Yasushi Rino ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Anticancer Agents ◽  
Quantitative Polymerase Chain Reaction ◽  
Gastric Cancer Tissue ◽  
Stage Ii ◽  
High Expression ◽  
Disease Stage ◽  
Cancer Tissue ◽  
Expression Levels

4070 Background: We have constructed a cDNA bank using mRNA extracted from frozen specimens of gastric cancer tissue and adjacent normal gastric mucosa and studied biomarkers for the individualized therapy of gastric cancer and the identification of new treatment targets. We report currently available results. Methods: We studied 227 patients in whom at least 5 years had elapsed since surgery for gastric cancer. The disease stage was IB in 29 patients, II in 66, III in 103, and IV in 29. Among the 139 patients who postoperatively received fluoropyrimidine anticancer agents, 82 with stage II or III disease were given adjuvant chemotherapy with S-1. A total 116 genes were selected as candidate biomarkers on the basis of the results of comprehensive DNA microarray analysis, extraction from a serial analysis of gene expression (SAGE) database, and other studies. The relative expression levels of these 116 genes in gastric cancer tissue and adjacent normal mucosa were measured in each case by a quantitative polymerase chain reaction assay using the cDNA databank described above, and the relations between clinical histopathological factors and treatment outcomes were examined. Results: In patients who underwent gastrectomy, high expression levels of the secreted protein acidic and rich in cysteine (SPARC), sulfatase 1 (SULF1), and inhibin, beta A (INHBA) genes were significantly associated with poor outcomes. In patients with stage II or III disease who received adjuvant chemotherapy with S-1, high expression levels of the insulin-like growth factor receptor 1 (IGF-1R), KIAA1199, thymidylate synthase (TS), and regenerating IV (Reg IV) genes were significantly associated with poor survival. Conclusions: Investigatory studies using a cDNA bank of biomarkers for gastric cancer suggested that expression levels of the SPARC, SULFI, and INHBA genes are useful prognostic factors in patients who undergo gastrectomy for gastric cancer. Expression levels of the IGF-1R, KIAA1199, TS, Reg IV, and INHBA genes may be useful biomarkers in patients who receive adjuvant chemotherapy with S-1.

Five-Year Outcomes of a Randomized Phase III Trial Comparing Adjuvant Chemotherapy With S-1 Versus Surgery Alone in Stage II or III Gastric Cancer

2011 ◽  
Vol 29 (33) ◽  
pp. 4387-4393 ◽  
Author(s):  
Mitsuru Sasako ◽  
Shinichi Sakuramoto ◽  
Hitoshi Katai ◽  
Taira Kinoshita ◽  
Hiroshi Furukawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Disease Stage ◽  
Relapse Free Survival ◽  
Free Survival ◽  
End Point

Purpose The first planned interim analysis (median follow-up, 3 years) of the Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer confirmed that the oral fluoropyrimidine derivative S-1 significantly improved overall survival, the primary end point. The results were therefore opened at the recommendation of an independent data and safety monitoring committee. We report 5-year follow-up data on patients enrolled onto the ACTS-GC study. Patients and Methods Patients with histologically confirmed stage II or III gastric cancer who underwent gastrectomy with D2 lymphadenectomy were randomly assigned to receive S-1 after surgery or surgery only. S-1 (80 to 120 mg per day) was given for 4 weeks, followed by 2 weeks of rest. This 6-week cycle was repeated for 1 year. The primary end point was overall survival, and the secondary end points were relapse-free survival and safety. Results The overall survival rate at 5 years was 71.7% in the S-1 group and 61.1% in the surgery-only group (hazard ratio [HR], 0.669; 95% CI, 0.540 to 0.828). The relapse-free survival rate at 5 years was 65.4% in the S-1 group and 53.1% in the surgery-only group (HR, 0.653; 95% CI, 0.537 to 0.793). Subgroup analyses according to principal demographic factors such as sex, age, disease stage, and histologic type showed no interaction between treatment and any characteristic. Conclusion On the basis of 5-year follow-up data, postoperative adjuvant therapy with S-1 was confirmed to improve overall survival and relapse-free survival in patients with stage II or III gastric cancer who had undergone D2 gastrectomy.

scholarly journals The Effect of Adjuvant Chemotherapy on Stage IV (T4N1-3M0 and T1-3N3M0) Gastric Cancer

2009 ◽  
Vol 41 (1) ◽  
pp. 19 ◽  
Author(s):  
Tae Kyung Ha ◽  
Min Sung Jung ◽  
Kang Hong Lee ◽  
Kyeong Geun Lee ◽  
Sung Joon Kwon
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Stage Iv

Adjuvant paclitaxel followed by oral fluoropyrimidines for gastric cancer: Safety data of the factorial phase III SAMIT trial.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 72-72
Author(s):  
Michiya Kobayashi ◽  
Akira Tsuburaya ◽  
Kazuhiro Yoshida ◽  
Shigefumi Yoshino ◽  
Yumi Miyashita ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Safety Data ◽  
Data Monitoring Committee ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Number Of Patients ◽  
Grade 3 ◽  
Lavage Cytology ◽  
Disease Free

72 Background: Adjuvant chemotherapy with fluoropyrimidine (FP) with or without platinum for gastric cancer (GC) has become standard almost worldwide; however, there has been no comparison among concurrent, sequential, and monotherapy. Paclitaxel (PTX) is one of key drugs in GC widely used as 2nd-line chemotherapy in Japan. Methods: SAMIT is a randomized, multicenter phase III study of FP (S1 or UFT) vs. PTX followed by FP in patients (pts) with gastric adenocarcinoma. Eligibility includes T3/T4, N0-2, M0 except for positive lavage cytology, chemotherapy- and radiotherapy- naive, being able to start chemotherapy 14 and 56 days after D2 gastrectomy. Pts received either UFT 267 mg/m2/day for 4w, q4w x 6 cycles (arm A); S1 80 mg/m2/day for 2w, q3w x 8 cycles (arm B); PTX 80 mg/m2 Day 1, 8 for the first 3w x 1 cycle, Day 1, 8, 15 q4w x 2 cycles, followed by UFT 267 mg/m2/day for 4w, q4w x 3 cycles (arm C); or PTX as in C, followed by S1 80 mg/m2/day for 2w, q3w x 4 cycles (arm D). The FP cycles was prolonged by 24w after ACTS-GC publication in 2007. Primary endpoint is disease-free survival and total number of patients was calculated to be1480 where 90% power for superiority of C+D group vs. A+B. The Independent Data Monitoring Committee undertook a review of the 1417 pts at the 2nd interim analysis in 2011. Results: Arm A (n=353), arm B (n=359), arm C (n=352), arm D (n=353) were well balanced for baseline factors. The compliance with UFT in arm A and S1 in B was 74% and 76% in the first 12 weeks, and 89% and 90% between week 37 and 48; that in arm C and D was 83% and 80% in the second 12 weeks, and 94% and 84% between week 37 and 48. Numbers of grade 3/4 hematological and non-hematological adverse events (AEs) were 3 and 46, 0 and 64, 5 and 35, and 16 and 67 for arm A, B, C, and D, respectively. Anorexia was the most common AE observed in 5.8%, 6.8%, 1.7%, and 5.1% for arm A, B, C, and D, respectively. There were 363/1323 (27%) deaths and 762/1323 (58%) of pts survived disease free. Conclusions: Adjuvant chemotherapy with sequential PTX and FP for GC was safe and the compliance of the FP part could be better than that of FP monotherapy. The final efficacy results will be formally assessed in 2012.

scholarly journals Role of systematic lymphadenectomy in postoperative mortality and morbidity in patients with gastric cancer

2004 ◽  
Vol 57 (7-8) ◽  
pp. 381-385
Author(s):  
Dejan Stevanovic ◽  
Dragan Radovanovic ◽  
Ivan Pavlovic ◽  
Nebojsa Mitrovic
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Gastric Carcinoma ◽  
Anastomotic Leakage ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Mortality And Morbidity ◽  
Systematic Lymphadenectomy

Introduction Surgical techniques and postoperative care for gastric cancer have significantly improved in recent years. However, whether postoperative morbidity and mortality rates after gastrectomy for gastric cancer have been reduced or not in recent years is still unclear. In this study we would like to point out the role of systematic lymphadenectomy in postoperative mortality and morbidity. Material and methods In this investigestion we analyzed two groups of patients. The first group of 126 patients with gastric carcinoma underwent peritumor lymphadenectomy D1. The second group of 114 patients with gastric carcinoma underwent more radical types of lymphadenectomy (D2, D2%, D3). In this study we analyzed differences between these two groups of patients in regard to:1) early postoperative mortality, 2) early postoperative complications and 3) long-term postoperative complications. Results Early postoperative mortality rate was 4.76% in D1 group and 5,26% in group with systematic lymphadenectomy (SL). 14.3% of patients in D1 group and 15.7% of patients in SL group had postoperative complications. The most frequent complications in D1 group were non-surgical complications of the respiratory system. In SL group the most common postoperative complications were anastomotic leakage (5/18, 27.77%) and wound infection (6/18. 33.3%). The most common long-term complications in both groups were: ventral postoperative hernia, anemia, small bowel obstruction and gallbladder calculosis. Discussion Early postoperative death occurred in patients with stage IV gastric cancer. The rates of anastomotic leakage, as main cause of early postoperative mortality and morbitity in patients with systematic lymphadenectomy, were reduced in the last few years with stapling surgery. Conclusions There were no significant differences in the postoperative mortality and morbidity rates between the two analyzed groups in our investigation.

scholarly journals Prognostic Factors for Elderly Gastric Cancer Patients who Underwent Gastrectomy

2021 ◽  
Author(s):  
Shunji Endo ◽  
Tomoki Yamatsuji ◽  
Yoshinori Fujiwara ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Performance Status ◽  
Postoperative Mortality ◽  
Prognostic Nutritional Index ◽  
Pathological Stage ◽  
Mortality And Morbidity ◽  
Operative Severity Score

Abstract Background: Patients with gastric cancer are aging in Japan. It is not clear which patients and which surgical procedures have survival benefits after gastrectomy. A multivariate analysis was performed.Methods: The medical records of 166 patients aged ≥80 years who underwent gastrectomy without macroscopic residual tumors were retrospectively reviewed. Univariate and multivariate analyses using Cox proportional hazard models were performed to detect prognostic factors for overall survival.Results: In univariate analyses, age (≥90 vs. ≥80, <85), performance status (3 vs. 0), the physiological score of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) (≥40 vs. ≥20, ≤29), Onodera’s prognostic nutritional index (<40 vs. ≥45), American Society of Anesthesiologists physical status (ASA-PS) (3, 4 vs. 1, 2), surgical approach (laparoscopic vs. open), extent of gastrectomy (total, proximal vs. distal), extent of lymphadenectomy (D1 vs. ≥D2), pathological stage (II-IV vs. I), and residual tumor (R1 vs. R0) were significantly correlated with worse overall survival. Multivariate analysis revealed that ASA-PS [3, 4 vs. 1, 2, hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.24-4.24], extent of gastrectomy (total vs distal, HR 2.17, 95% CI 1.10-4.31), (proximal vs. distal, HR 4.05, 95% CI 1.45-11.3), extent of lymphadenectomy (D0 vs. ≥D2, HR 12.4, 95% CI 1.58-97.7) and pathological stage were independent risk factors for mortality.Conclusions: ASA-PS was a useful predictor for postoperative mortality. Gastrectomy including cardia and excessive limitation of lymphadenectomy are best avoided.

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