Adjuvant chemotherapy in a unique population of patients with gastric cancer undergoing surgery.
OBJECTIVE
Total gastrectomy with D2 dissection theoretically removes the gross primary tumor with its potential route of dissemination, that is locoregional lymph nodes. Complementary therapy for the control of systemic microscopic disease should be taken into consideration in patients whom surgery with curative intent was performed.


METHODS
Twenty-eight patients with moderately differentiated, locally advanced gastric carcinoma underwent total gastrectomy with D2 lymph node dissection. The operative mortality rate was 0% in this series. Fifteen patients received six courses of adjuvant 5-FU + leucovorin in doses of 425 mg/m2/d and 20 mg/m2/d respectively in five-day cycles month ly. The remaining 13 patients constituted the control (surgery only) group.


RESULTS
The mean disease-free and overall survival rates were 41 and 48 months (p: 0.78) and 42 and 53 months (p: 0.43) in the control and chemotherapy groups, respectively. The odds ratio for crude mortality was 0.7.


CONCLUSIONS
Although statistical significance has not been achieved in this study, a trend toward adjuvant chemotherapy has emerged in that unique group of patients with moderately differentiated (intestinal type) adenocarcinoma of the stomach undergoing curative surgery.
Uslu
A
A
SSK Izmir Teaching Hospital, Department of General Surgery and Organ Transplantation Center, Izmir, Turkey.
Karaca
C
C
Nart
A
A
Adagülü
H
H
Aykas
A
A
Gürkan
A
A
Dogan
M
M
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D000231:Adenocarcinoma, Papillary / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D004359:Drug Therapy, Combination; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*
D000964:Antimetabolites, Antineoplastic; D002955:Leucovorin; D005472:Fluorouracil