Neoadjuvant chemotherapy versus surgery alone for locally advanced gastric cancer: a retrospective comparative study.
OBJECTIVE
Preoperative chemotherapy is considered an effective treatment option for patients with gastric cancer. We retrospectively evaluated neoadjuvant chemotherapy with oxaliplatin, leucovorin and 5-flurouracil (OLF) in patients with locally advanced gastric cancer to determine its feasibility, as well as impact on the curative resection rate and patients' survival.


METHODS
A total of 87 patients with locally advanced gastric cancer that underwent preoperative chemotherapy combined with surgery or surgery alone were randomly matched according to the clinical TNM stage. The clinical responses to chemotherapy were assessed. The curative rate, postoperative complications and patients' survival between both groups were compared.


RESULTS
The two groups were well matched. Complete or partial response was observed in 51.7% (15/29) of patients in the OLF group, and three (10.3%) of them had complete pathologic response. The curative resection rates were 89.7% in the OLF group and 77.6% in the surgery alone group. The postoperative complications were equal for both groups. The mean survival is 20.6 months in the OLF group vs. 19.9 months in the surgery alone group (p=0.02).


CONCLUSIONS
Neoadjuvant chemotherapy using OLF combination is active in gastric cancer and the toxicity level is acceptable. This treatment improves the curative resection rate and patients' survival in locally advanced gastric cancer.
Wang
Lin Bo
LB
Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, China.
Shen
Jian Guo
JG
Xu
Chao Yang
CY
Chen
Wen Jun
WJ
Song
Xiang Yang
XY
Yuan
Xiao Ming
XM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil