Impact of neoadjuvant chemotherapy on surgical and pathological results of gastric cancer patients: A case-control study.

Autor: Charruf AZ; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil., Ramos MFKP; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil., Pereira MA; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil., Dias AR; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil., de Castria TB; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil., Zilberstein B; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil., Cecconelo I; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil., Ribeiro U; Gastrointestinal Surgery Department, Instituto do Câncer - Universidade de Sao Paulo, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2020 Apr; Vol. 121 (5), pp. 833-839. Date of Electronic Publication: 2020 Jan 14.
DOI: 10.1002/jso.25839
Abstrakt: Background and Objective: Neoadjuvant chemotherapy (NACT) followed by radical surgery represents a treatment option for patients with advanced gastric cancer (GC). This case-control study aimed to evaluate the clinicopathological characteristics and surgical outcomes of GC patients who received NACT, and its impact on survival.
Methods: We retrospectively reviewed all patients with GC who underwent gastrectomy. A total of 45 cases with NACT were matched with consecutive 45 patients who underwent upfront gastrectomy for the following characteristics: gender, age, gastrectomy type, lymphadenectomy extent, American Society of Anesthesiologists class, histological type, cT and cN.
Results: NACT group had smaller tumors (4.9 vs 6.8 cm P = .006), lower lymphatic invasion rate (40% vs 73.3%, P = .001), lower venous invasion rate (18% vs 46.7%, P = .003) and lower perineural invasion rate (35% vs 77.8%, P < .0001). The ypTNM stage was lower in patients treated with NACT (P < .001). The major postoperative complication (POC) rate was lower in NACT patients (6.7% vs 24.4%, P = .02), as was hospital length of stay (10.8 vs 17 days, P = .005).
Conclusions: NACT allowed nodal and tumor downstaging. In addition, patients who underwent NACT had fewer POC and shorter length of hospital stay.
(© 2020 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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