[Application of neoadjuvant chemotherapy in laparoscopic gastrectomy for advanced gastric cancer].
OBJECTIVE
To explore the benefit of neoadjuvant chemotherapy in advanced gastric cancer patients treated by laparoscopy.


METHODS
Fifteen patients with histologically proved gastric adenocarcinomas (stages II(, III(, IIII(M(0)) were treated with FOLFOX7 neoadjuvant chemotherapy followed by laparoscopy between June 2005 and March 2007( trial group). Thirty patients were assigned to the control group with only laparoscopic treatment in the same period. The clinicopathological data were compared between two groups.


RESULTS
All the patients in trial group accepted four cycles of preoperative chemotherapy and the toxicity was less than grade 3. Two of them achieved complete response, 10 achieved partial response and 3 kept stable disease. Ten patients of trial group underwent laparoscopic-assisted radical gastrectomy. The rates of R(0)-resection(80.0%) and pN(0) (60.0%) in trial group were significantly higher than those in control group(46.7% and 20.0%), while the rate of positive lymph node 11.0%(34/309) was significantly lower than that of control group 23.8%(142/596). The operation time and postoperative complication were similar in two groups.


CONCLUSIONS
Advanced gastric cancer after neoadjuvant chemotherapy can be down-regulated in the stage, increase the rate of R(0)-resection, diminish the infiltration extent of tumor, decrease the metastasis of lymph node, and increase the possibility of laparoscopic radical gastrectomy.
Zhou
Dong-lei
DL
Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China.
Zheng
Cheng-zhu
CZ
Li
Ji-hui
JH
Yin
Kai
K
Ke
Chong-wei
CW
Liu
Hong-tao
HT
Hu
Xu-guang
XG
Chen
Dan-lei
DL
Zhang
Ding-yu
DY
D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome