Prognostic factors and significance of postoperative adjuvant chemotherapy in patients with advanced gastric cancer undergoing neoadjuvant chemotherapy followed by gastrectomy.
- Resource Type
- Academic Journal
- Authors
- Motoori M; Department of Surgery, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-Ku, Osaka, 558-8558, Japan. mmotoori@gh.opho.jp.; Kishi K; Department of Surgery, Osaka Police Hospital, Osaka, Japan.; Yamamoto K; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.; Takeno A; Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan.; Hara H; Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.; Murakami K; Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.; Hamakawa T; Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan.; Nakahara Y; Department of Surgery, Osaka Police Hospital, Osaka, Japan.; Masuzawa T; Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.; Omori T; Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan.; Kurokawa Y; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.; Fujitani K; Department of Surgery, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-Ku, Osaka, 558-8558, Japan.; Doki Y; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
- Source
- Publisher: Springer International Country of Publication: Japan NLM ID: 9204360 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1436-2813 (Electronic) Linking ISSN: 09411291 NLM ISO Abbreviation: Surg Today Subsets: MEDLINE
- Subject
- Language
- English
Purpose: In Japan, gastrectomy with D2 lymph node dissection and postoperative adjuvant chemotherapy are the standard treatments for locally advanced gastric cancer. Neoadjuvant chemotherapy (NAC) is not affected by postgastrectomy syndromes or postoperative complications. This multicenter retrospective study investigated the prognostic factors and significance of postoperative adjuvant chemotherapy in patients with advanced gastric cancer who underwent NAC followed by gastrectomy.
Methods: Consecutive patients (n = 221) with advanced gastric cancer who underwent NAC followed by curative surgery were enrolled in this study. Prognostic factors including postoperative adjuvant chemotherapy were investigated using univariate and multivariate analyses.
Results: A multivariate analysis revealed that pathological lymph node metastasis (ypN) status and postoperative adjuvant chemotherapy were independent prognostic factors for the overall and relapse-free survival. Forty-five patients (20.4%) did not receive postoperative adjuvant chemotherapy. There were no significant differences between patients with and without adjuvant chemotherapy for all factors, except age. The most common reason for not undergoing postoperative adjuvant chemotherapy was a poor condition (n = 23).
Conclusions: ypN status and postoperative adjuvant chemotherapy were independent prognostic factors in gastric cancer patients who underwent NAC followed by curative gastrectomy. It is important to maintain the patient's condition during NAC and the perioperative period so that they can receive postoperative adjuvant chemotherapy.
(© 2024. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.)