Neoadjuvant Chemotherapy in Local Advanced Gastric Cancer

authors:

avatar Abdolhassan Talaiezadeh 1 , * , avatar Amir Jafar Modirgolestan 2 , avatar Hodjatollah Shahbazian 3

Associate Professor of Surgery, Surgical Oncologist, Cancer, Environmental and Petroleum Pollutants Research Center Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
General surgery, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Assistant Professor of Radiotherapy and Oncology, Department of Radiotherapy and Oncology, Golestan Hospital, Cancer Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Jundishapur Journal of Oncology: Vol.1, issue 1; 21-24
published online: March 20, 2015
article type: Research Article
DOI: https://doi.org/10.22118/jjo.2015.49185

how to cite: Talaiezadeh A, Modirgolestan A J, Shahbazian H. Neoadjuvant Chemotherapy in Local Advanced Gastric Cancer. Jundishapur J Oncol. 2015;1(1):e148103. https://doi.org/10.22118/jjo.2015.49185.

Abstract

Background: Gastric cancer remains a major cause of cancer death in Iran despite a significant decreasing inci-dence in western countries. Surgery alone has not been effective for treatment of locoregional gastric cancer be-cause of the low rate of curative resection and high incidence of local recurrence and distant metastases. Our aim was to determine the resectability of tumor after neoadjuvant chemotherapy.
Material and Methods: Fourteen patients with clinical stage III gastric adenocarcinoma that initially seemed to be unresectable by laparoscopy were treated with three cycles of cisplatin 60 mg/m2, 5-Fluorouracil 750 mg/m2 and Epirubicin 50 mg/m2 three weeks before surgery. 
Results: Thirteen patients were operable for surgery after neoadjuvant chemotherapy (Pvalue= 0.001), while one patient was not operable due to developing distal metastasis. Twelve (85.85%) patients were resectable with patho-logic report of R 0 and, one (7.15%) patient was reported R1, (Pvalue= 0.001). A total number of 97 patients, with mediastinal involvement by primary masses, were contributed in this study. Biopsy was taken through the several ways. The numbers of 52(53.60%) “Lymphoma” and 45 (46.40%) cases with other pathologic results were dominantly detected with “tuberculosis”. Two cases of lymphoma was found in two referred cases with MMs <10 years and the overall incidence of involvement was begun from first to fifth dec-ades with the peak in third to fourth decades along with mostly anterior mediastinal locations.
Conclusion: This study shows that neoadjuvant chemotherapy improves operability and resectability of the tumor in patients with local advanced gastric adenocarcinoma.