期刊
YONSEI MEDICAL JOURNAL
卷 54, 期 4, 页码 888-894出版社
YONSEI UNIV COLL MEDICINE
DOI: 10.3349/ymj.2013.54.4.888
关键词
Gastric cancer; neoadjuvant chemotherapy; neoadjuvant chemoradiotherapy; gastrectomy; pathologic response; prognosis
资金
- Basic Science Research Program through the National Research Foundation of Korea (NRF)
- Ministry of Education, Science, and Technology [2011-0011301]
- National Research Foundation of Korea [2011-0011301] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
Purpose: Although neoadjuvant therapy has been accepted as a treatment option in locally-advanced gastric cancer, its prognostic value has been difficult to evaluate. Materials and Methods: Seventy-four gastric cancer patients who underwent gastrectomy after neoadjuvant treatment were divided into two groups according to the pathologic response: favorable (ypT0) and others (ypT1-4). The clinicopathologic characteristics, predictive factors for pathologic response, and oncologic outcome were evaluated. Results: Eleven patients (14.8%) demonstrated ypT0 and the remaining 63 patients (85.2%) were ypT1-4. Chemoradiotherapy (CCRTx) rather than chemotherapy (CTx) was the only predictive factor for a favorable pathologic response. Chemotherapeutic factors and tumor marker levels did not predict pathologic response. The 1-, 2-, and 3-year disease-free survivals were 83.4%, 70%, and 52.2%. The 1-, 3-, 5-year overall survivals were 88.5%, 67.5%, and 51.2%, respectively. Although a complete pathologic response (ypT0N0M0) was achieved in 7 patients, 28.6% of them demonstrated recurrence of the tumor within 6 months after curative surgery. Conclusion: CCRTx rather than CTx appears to be more effective for achieving good pathologic response. Although favorable pathologic response has been achieved after neoadjuvant treatment, the survival benefit remains controversial.
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