Response to neoadjuvant chemotherapy and effects of tumor regression in gastric cancer

Aims: Aim of this study is the evaluation of the effects induced by neoadjuvant chemotherapy (NACT) and its impact oil survival on a series of locally advanced gastric carcinomas. Methods: Downstaging was assessed comparing pre-treatment clinical and laparoscopic staging with post-operative pathologic staging on 30 consecutive patients who completed a 3-year follow-up. Tumor downstaging and the grade of pathologic response were included in a statistical correlation between tumor regression induced by NACT and 3-year survival. Results: In this series tumor downstaging was obtained in 13 out of 30 patients. After the completion of 3-year follow-up, overall Survival was > 37.5 months with an overall survival rate of 56.7%; this figure reached up to 70.8% in those cases who benefited from a RO-resection (24/30 patients: RO-resection rate 80.0%). Conclusions: In this study the 3-year survival for locally advanced gastric cancer treated by NACT prior to D2 surgical resection, compares favourably with historical series treated by surgery alone. Patients who obtained T-downstaging and subsequently benefited from a RO-resection had a definitely better chance of cure, according to a complete 3-year follow-up. (c) 2006 Elsevier Ltd. Ail rights reserved.