title: [Strategy for the treatment of Stage IV gastric cancer with preoperative chemotherapy].
abstract: In 2007, we began using neoadjuvant chemotherapy for the treatment of Stage IV gastric cancer and then performing R0/1 surgery in patients in whom chemotherapy was effective. Here, we evaluate the use of this therapeutic strategy combining chemotherapy and surgery for the treatment of Stage IV gastric cancer. The subjects of our investigation were 46 patients with Stage IV gastric cancer treated from 2007 through 2012. We divided these patients into the NAC group (19 patients), in whom we performed R0/1 surgery after chemotherapy, and the Cx group (27 patients), who continued chemotherapy. We also included 79 patients with Stage IV gastric cancer treated from 2001 to 2006, divided into the OPE group (36 patients), in whom we performed R0/1 surgery without neoadjuvant chemotherapy, and the NC group (43 patients), in whom we performed R2 surgery. We plotted the survival curves of these 4 groups. The chemotherapy protocols used were S-1+cisplatin( CDDP) and S-1+docetaxel( DOC). The disease control rate of these chemotherapies was 72%, and R0/1 surgery was performed in 53.8% of patients with liver metastasis, 62.5% of those with paraaortic lymph node (PALN) metastasis, 29.4% of those with peritoneal metastasis, 100% of patients with T4N2 disease, and 0% of patients with distant metastasis. The 2-year survival rates of the NAC, OPE, Cx, and NC groups were 69%, 55%, 0%, and 20%, respectively. The 5-year survival rates of the NAC, OPE, Cx, and NC groups were 35%, 30%, 0%, and 5%, respectively.
authors.affiliation: Dept. of Surgery, Hyogo Prefectural Awaji Medical Center.
authors.forename: Katsufumi
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.forename: Tatsurou
authors.initials: T
authors.lastname: Ohishi
authors.forename: Outen
authors.initials: O
authors.lastname: Takahashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakahira
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ueda
authors.forename: Tarou
authors.initials: T
authors.lastname: Kawashima
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Makidono
authors.forename: Takeshi
authors.initials: T
authors.lastname: Doi
authors.forename: Koutarou
authors.initials: K
authors.lastname: Eriguchi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Arase
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D004338:Drug Combinations; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D043823:Taxoids; C079198:S 1 (combination); D005641:Tegafur; D000077143:Docetaxel; D010094:Oxonic Acid; D002945:Cisplatin