BACKGROUND: The prognosis of gastric cancer with para-aortic lymph node (PAN) metastasis is poor. We applied triple combination chemotherapy with docetaxel, cisplatin, and S-1 (DCS therapy) as pre-operative chemotherapy and investigated the outcome of the combination of this therapy and gastrectomy with para-aortic lymph node dissection (PAND). METHODS: We retrospectively identified 44 patients with pathologically positive PAN who underwent curative surgery at Kanazawa University Hospital between 1990 and 2008. Among the 44 patients, 16 received pre-operative DCS therapy and subsequent surgical resection after two courses of the therapy. RESULTS: Pre-operative DCS therapy showed high clinical response ratio (68.8%) and disease control ratio (100%). The pathological response ratio of resected specimen was 87.5%. At 2 years after surgery, the overall survival ratio was 93.8% and relapse-free survival was 75.0%. Pre-operative DCS therapy was only independent prognostic factor in multivariate analysis. Grade 3/4 toxicity was observed only in 25.0% of patients who underwent DCS therapy. Surgical complication was observed in 31.3% of patients, and this ratio was equal to that of patients who did not receive DCS therapy. CONCLUSION: Multimodal therapy comprising combined pre-operative DCS therapy and gastrectomy with PAND was extremely effective and feasible for advanced gastric cancer with PAN metastasis.
BACKGROUND: The prognosis of gastric cancer with para-aortic lymph node (PAN) metastasis is poor. We applied triple combination chemotherapy with docetaxel, cisplatin, and S-1 (DCS therapy) as pre-operative chemotherapy and investigated the outcome of the combination of this therapy and gastrectomy with para-aortic lymph node dissection (PAND). METHODS: We retrospectively identified 44 patients with pathologically positive PAN who underwent curative surgery at Kanazawa University Hospital between 1990 and 2008. Among the 44 patients, 16 received pre-operative DCS therapy and subsequent surgical resection after two courses of the therapy. RESULTS: Pre-operative DCS therapy showed high clinical response ratio (68.8%) and disease control ratio (100%). The pathological response ratio of resected specimen was 87.5%. At 2 years after surgery, the overall survival ratio was 93.8% and relapse-free survival was 75.0%. Pre-operative DCS therapy was only independent prognostic factor in multivariate analysis. Grade 3/4 toxicity was observed only in 25.0% of patients who underwent DCS therapy. Surgical complication was observed in 31.3% of patients, and this ratio was equal to that of patients who did not receive DCS therapy. CONCLUSION: Multimodal therapy comprising combined pre-operative DCS therapy and gastrectomy with PAND was extremely effective and feasible for advanced gastric cancer with PAN metastasis.
Authors: Salah-Eddin Al-Batran; Nils Homann; Claudia Pauligk; Gerald Illerhaus; Uwe M Martens; Jan Stoehlmacher; Harald Schmalenberg; Kim B Luley; Nicole Prasnikar; Matthias Egger; Stephan Probst; Helmut Messmann; Markus Moehler; Wolfgang Fischbach; Jörg T Hartmann; Frank Mayer; Heinz-Gert Höffkes; Michael Koenigsmann; Dirk Arnold; Thomas W Kraus; Kersten Grimm; Stefan Berkhoff; Stefan Post; Elke Jäger; Wolf Bechstein; Ulrich Ronellenfitsch; Stefan Mönig; Ralf D Hofheinz Journal: JAMA Oncol Date: 2017-09-01 Impact factor: 31.777
Authors: Sang-Yong Son; Chang Min Lee; Ju-Hee Lee; Sang-Hoon Ahn; Jin Won Kim; Kuhn-Uk Lee; Do Joong Park; Hyung-Ho Kim Journal: J Korean Surg Soc Date: 2013-04-24