title: Cancer chemotherapy chemosensitivity testing is useful in evaluating the appropriate adjuvant cancer chemotherapy for stages III/IV gastric cancers without peritoneal dissemination.
abstract: BACKGROUND
  Because of the low chemosensitivity of gastric cancer to conventional antitumor agents, the role of adjuvant chemotherapy for patients with advanced gastric cancer is controversial. We have previously proposed the necessity to evaluate the appropriateness of particular adjuvant cancer chemotherapies in individual advanced gastric cancer patients using chemosensitivity testing. In the present study, we compared the chemosensitivity and clinical outcomes of patients with Stages III and IV gastric cancer.
  
  
  METHODS
  A total of 282 patients with advanced gastric cancer were analyzed retrospectively in terms of chemosensitivity as detected by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and survival outcome after surgery. Patients were split into groups according to Stage III or IV gastric cancer, then categorized into those that received surgery without chemotherapy (surgery-alone), and those that received adjuvant chemotherapy, for which all the evaluable cases were further divided into sensitive and resistant cases as determined by MTT assay.
  
  
  RESULTS
  For Stage III gastric cancer patients, the sensitive group had a more favorable survival outcome than the other two groups. For Stage IV gastric cancer patients, the sensitive groups, had a more favorable survival outcome than the other two groups, but only in the absence of peritoneal dissemination.
  
  
  CONCLUSIONS
  Chemosensitivity testing, based on the MTT assay, was useful in evaluating the appropriate cancer chemotherapy for patients with Stages III/IV gastric cancer without peritoneal dissemination.
authors.affiliation: Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. tkubota@sc.itc.keio.ac.jp
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kubota
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Egawa
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Otani
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Furukawa
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Saikawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kumai
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004354:Drug Screening Assays, Antitumor; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage; D013778:Tetrazolium Salts; D013844:Thiazoles; D016896:Treatment Outcome; D014498:Uracil / Q000008:administration & dosage
chemical_list: D013778:Tetrazolium Salts; D013844:Thiazoles; D005641:Tegafur; D016685:Mitomycin; D014498:Uracil; C022616:thiazolyl blue; D002945:Cisplatin; D005472:Fluorouracil