PREOPERATIVE CHEMOTHERAPY VERSUS UPFRONT SURGERY FOR ADVANCED GASTRIC CANCER: A PROPENSITY SCORE MATCHING ANALYSIS

BACKGROUND: Surgical resection remains the main curative therapeutic modality for RESUMO -Racional: O tratamento de escolha para pacientes com hipertensao portal advanced gastric cancer. Recently, the association of preoperative chemotherapy has allowed the improvement of results without increasing surgical complications. AIMS: To evaluate the surgical esquistossomotica com sangramento de varizes e a desconexao azgo-portal mais and oncological outcomes of preoperative chemotherapy in a real-world setting. METHODS: A esplenectomia (DAPE) associada a trai doscopica. Porem, estudos ostrm aumento retrospective review of gastric cancer patients who underwent gastrectomy was performed. do calibre das varizes em alguns pacientes durante segimento em lngo prazo. Objetivo: Patients were divided into two groups for analysis: upfro nt surgery and preoperative chemotherapy. Avaliar o impacto da DAPE e tratamento endoscopico pos-operatorio no comportameno The propensity score matching analysis, including 9 variables, was applied to adjust for potential das varizes esofagicas e recidiva hemorragica, de pacientes esquistossomoticos. Metodos: confounding factors. RESULTS: Of the 536 patients included, 112 (20.9%) were referred for preoperative chemotherapy. Before the propensity score matching analysis, the groups were Foram estudados 36 pacientes com seguimento superior a cinco anos, distribuidos em different in terms of age, hemoglobin level, node metastasis at clinical stage-status, and extent dois grupos: queda da pressao portal abaixo de 30% e acima de 30% comparados com o of gastrectomy. After the analysis, 112 patients were stratified for each group. Both were similar calibre ds varize esofagicas no pos-operaorio precoce tardio ale do indice de reciiva for all variables assigned in the score. Patients in the preope rative chemotherapy group had less hemorragica. Resultados advanced postoperative p staging (p=0.010), postoperative n staging (p<0.001), and pTNM stage esofagicas que, durante o seguimento aumentaram de calibre e foram controladas com (p<0.001). Postoperative complications, 30-and 90-days mortality were similar between both groups. Before the propensity score matching analysis, there was no difference in survival between the groups. After the analysis, patients in the preoperative chemotherapy group had better overall o comportamento do calibre das varizes no pos-operatorio precoce nem tardio nm os survival compared to upfront surgery group (p=0.012). Multivariate analyses demonstrated that indices de recidiva hemorragica. Conclusao American Society of Anesthesiologists III/IV category and the presence of lymph node metastasis were factors significantly associated with worse overall survival. CONCLUSIONS: Preoperative operatorios precoces ou tardios. A comparacao entre a queda de pressao do portal e as chemotherapy was associated with increased survival in gastric cancer. There was no difference in the postoperative complication rate and mortality compared to upfront surgery.

Automated summary

Preoperative chemotherapy improves surgical and oncological outcomes in gastric cancer patients and leads to increased overall survival.