Analysis on Effect of Neoadjuvant Chemotherapy of Different Differentiated Grades of Locally Advanced Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHAOGuo-jie ^1,2 , ZHANGYun-xin ¹ , WANGBo ¹ , ZHANGZhen ¹ ,  SUNLi-bo ¹

1. Department of Gastrointestinal Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, Jilin Province, China;
2. Department of General Surgery, The Handan Central Hospital of Hebei Province, Handan 056000, Hebei Province, China;

Corresponding author：

SUNLi-bo, Email: sunlibo0431@sina.com

Keywords：

Locally advanced gastric cancer; Preoperative chemotherapy; Pathological differentiation; Surgery

DOI：

10.7507/1007-9424.20150122

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the influence of pathological differentiation in the effect of preoperative chemo-therapy for patients with locally advanced gastric cancer (LAGC). Methods Thirty-two patients with LAGA received preoperative chemotherapy with oxaliplatin and capecitabine (XELOX regimen).According to the pathological examina-tion, patients were classified into better (well and moderate, 16 cases) and poorly (16 cases) differentiated groups, and the clinical response rate, type of gastrectomy, and negative tumor residual rate were compared between the two groups.Morphological changes and toxic reactions were monitored after chemotherapy. Results The results showed that the clinical response rate in the better differentiated group was significantly higher than that in the poorly differentiated group (100% vs.6.4%, P=0.000).The partial gastrectomy rate in the better differentiated group was significantly higher than that in the poorly differentiated group (87.5% vs.25.0%, P=0.000).A significant shrinking of tumor size and necrosis of tumor tissues caused by chemotherapy could be observed. Conclusion The better differentiated group with locally advanced gastric cancer is suitable for preoperative chemotherapy with XELOX regimen, and as a result of effective preoperative chemotherapy, much more gastric tissue can be preserved for better differentiated group.

Citation： ZHAOGuo-jie, ZHANGYun-xin, WANGBo, ZHANGZhen, SUNLi-bo. Analysis on Effect of Neoadjuvant Chemotherapy of Different Differentiated Grades of Locally Advanced Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(4): 464-467. doi: 10.7507/1007-9424.20150122 Copy

1.	Whelan SL.Cancer incidence in Five Continents.Coding practices.Lyon France, IARC Sci Publ, 1992:31-38.
2.	邹晓农, 段纪俊, 黄甫小梅, 等.2004~2005全国死因回顾抽样调查胃癌死亡率分析.中华预防医学杂志, 2010, 44(5):390-397.
3.	Lee JH, Yom CK, Han HS.Comparison of long-term outcomes of laparoscopy-assisted and open distal gastrectomy for early gastric cancer.Surg Endosc, 2009, 23(8):1759-1763.
4.	Ajani JA, Winter K, Okawara GS, et al.PhaseⅡtrial of preopera-tive chemoradiation in patients with localized gastric adenocarci-noma (RTOG 9904):quality of combined modality therapy and pathologic response.J Clin Oncol, 2006, 24(24):3953-3958.
5.	Li W, Qin J, Sun YH, et al.Neoadjuvant chemotherapy for advanced gastric cancer:a meta-analysis.World J Gastroenterol, 2010, 16(44):5621-5628.
6.	贺岭凤, 杨克虎, 田金辉, 等.胃癌新辅助化疗的系统评价——Meta分析.癌症, 2008, 27(4):407-412.
7.	Ychou M, Boige V, Pignon JP, et al.Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adeno-carcinoma:an FNCLCC and FFCD multicenter phaseⅢtrial.J Clin Oncol, 2011, 29(13):1715-1721.
8.	Fields RC, Strong VE, Gönen M, et al.Recurrence and survival after pathologic complete response to preoperative therapy followed by surgery for gastric or gastrooesophageal adenocarcinoma.Br J Cancer, 2011, 104(12):1840-1847.
9.	Díaz-González JA, Rodríguez J, Hernández-Lizoain JL, et al.Patterns of response after preoperative treatment in gastric cancer.Int J Radiat Oncol Biol Phys, 2011, 80(3):698-704.
10.	Cunningham D, Allum WH, Stenning SP, et al.Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer.N Engl J Med, 2006, 355(1):11-20.
11.	Stahl M, Walz MK, Stuschke M, et al.PhaseⅢcomparison of preo-perative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophago-gastric junction.J Clin Oncol, 2009, 27(6):851-856.
12.	Ge L, Wang HJ, Yin D, et al.Effectiveness of 5-flurouracil-based neoadjuvant chemotherapy in locally-advanced gastric/gastroesophageal cancer:a meta-analysis.World J Gastroenterol, 2012, 18(48):7384-7393.
13.	Pepek JM, Chino JP, Willett CG, et al.Preoperative chemoradio-therapy for locally advanced gastric cancer.Radiat Oncol, 2013, 8(1):6-12.
14.	Zhang C, Li G, Fan C, et al.Comparison of efficacy of different route of administration of chemotherapy on unresectable, advanced gastric cancer.World J Surg Oncol, 2012, 10(8):162-170.
15.	Webber C, Gospodarowicz M, Sobin LH, et al.Improving the TNM classification findings from a 10-year continuous literature review.Int J Cancer, 2014, 135(2):371-378.
16.	Park YH, Kim BS, Ryoo BY, et al.A phase II study of capecitabine plus 3-weekly oxaliplatin as first-line therapy for patients with advanced gastric cancer.Br J Cancer, 2006, 94(7):959-963.
17.	Thuss-Patience PC, Kretzschmar A, Repp M, et al.Docetaxel and continuous-infusion fluorouracil versus epirubicin, cisplatin, and fluorouracil for advanced gastric adenocarcinoma:a randomized phaseⅡstudy.J Clin Oncol, 2005, 23(3):494-501.
18.	Kang HJ, Chang HM, Kim TW, et al.PhaseⅡstudy of capecitabine and cisplatin as first-line combination therapy in patients with gastric cancer recurrent after fluoropyrimidine-based adjuvant chemotherapy.Br J Cancer, 2005, 92(2):246-251.
19.	Blakely AM, Miner TJ.Surgical considerations in the treatment of gastric cancer.Gastroenterol Clin North Am, 2013, 42(2):337-357.
20.	Shin D, Park SS.Clinical importance and surgical decision-making regarding proximal resection margin for gastric cancer.World J Gastrointest Oncol, 2013, 5(1):4-11.
21.	Yoo CH, Noh SH, Shin DW, et al.Recurrence following curative resection for gastric carcinoma.Br J Surg, 2000, 87(3):236-242.
22.	D'Angelica M, Gonen M, Brennan MF, et al.Patterns of initial recurrence in completely resected gastric adenocarcinoma.Ann Surg, 2004, 240(5):808-816.
23.	Nakajima T, Ota K, Ishihara S, et al.Combined intensive chemo-therapy and radical surgery for incurable gastric cancer.Ann Surg Oncol, 1997, 4(3):203-208.
24.	Wilke H, Preusser P, Fink U, et al.Preoperative chemotherapy in locally advanced and nonresectable gastric cancer:a phase II study with etoposide, doxorubicin, and cisplatin.J Clin Oncol, 1989, 7(9):1318-1326.
25.	Wilke H, Stahl M, Fink U, et al.Preoperative chemotherapy for unresectable gastric cancer.World J Surg, 1995, 19(2):210-215.
26.	Cascinu S, Scartozzi M, Labianca R, et al.High curative resection rate with weekly cisplatin, 5-fluorouracil, epidoxorubicin, 6S-leucovorin, glutathione, and filgastrim in patients with locally advanced, unresectable gastric cancer:a report from the Italian Group for the Study of Digestive Tract Cancer (GISCAD).Br J Cancer, 2004, 90(8):1521-1525.

1. Whelan SL.Cancer incidence in Five Continents.Coding practices.Lyon France, IARC Sci Publ, 1992:31-38.
2. 邹晓农, 段纪俊, 黄甫小梅, 等.2004~2005全国死因回顾抽样调查胃癌死亡率分析.中华预防医学杂志, 2010, 44(5):390-397.
3. Lee JH, Yom CK, Han HS.Comparison of long-term outcomes of laparoscopy-assisted and open distal gastrectomy for early gastric cancer.Surg Endosc, 2009, 23(8):1759-1763.
4. Ajani JA, Winter K, Okawara GS, et al.PhaseⅡtrial of preopera-tive chemoradiation in patients with localized gastric adenocarci-noma (RTOG 9904):quality of combined modality therapy and pathologic response.J Clin Oncol, 2006, 24(24):3953-3958.
5. Li W, Qin J, Sun YH, et al.Neoadjuvant chemotherapy for advanced gastric cancer:a meta-analysis.World J Gastroenterol, 2010, 16(44):5621-5628.
6. 贺岭凤, 杨克虎, 田金辉, 等.胃癌新辅助化疗的系统评价——Meta分析.癌症, 2008, 27(4):407-412.
7. Ychou M, Boige V, Pignon JP, et al.Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adeno-carcinoma:an FNCLCC and FFCD multicenter phaseⅢtrial.J Clin Oncol, 2011, 29(13):1715-1721.
8. Fields RC, Strong VE, Gönen M, et al.Recurrence and survival after pathologic complete response to preoperative therapy followed by surgery for gastric or gastrooesophageal adenocarcinoma.Br J Cancer, 2011, 104(12):1840-1847.
9. Díaz-González JA, Rodríguez J, Hernández-Lizoain JL, et al.Patterns of response after preoperative treatment in gastric cancer.Int J Radiat Oncol Biol Phys, 2011, 80(3):698-704.
10. Cunningham D, Allum WH, Stenning SP, et al.Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer.N Engl J Med, 2006, 355(1):11-20.
11. Stahl M, Walz MK, Stuschke M, et al.PhaseⅢcomparison of preo-perative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophago-gastric junction.J Clin Oncol, 2009, 27(6):851-856.
12. Ge L, Wang HJ, Yin D, et al.Effectiveness of 5-flurouracil-based neoadjuvant chemotherapy in locally-advanced gastric/gastroesophageal cancer:a meta-analysis.World J Gastroenterol, 2012, 18(48):7384-7393.
13. Pepek JM, Chino JP, Willett CG, et al.Preoperative chemoradio-therapy for locally advanced gastric cancer.Radiat Oncol, 2013, 8(1):6-12.
14. Zhang C, Li G, Fan C, et al.Comparison of efficacy of different route of administration of chemotherapy on unresectable, advanced gastric cancer.World J Surg Oncol, 2012, 10(8):162-170.
15. Webber C, Gospodarowicz M, Sobin LH, et al.Improving the TNM classification findings from a 10-year continuous literature review.Int J Cancer, 2014, 135(2):371-378.
16. Park YH, Kim BS, Ryoo BY, et al.A phase II study of capecitabine plus 3-weekly oxaliplatin as first-line therapy for patients with advanced gastric cancer.Br J Cancer, 2006, 94(7):959-963.
17. Thuss-Patience PC, Kretzschmar A, Repp M, et al.Docetaxel and continuous-infusion fluorouracil versus epirubicin, cisplatin, and fluorouracil for advanced gastric adenocarcinoma:a randomized phaseⅡstudy.J Clin Oncol, 2005, 23(3):494-501.
18. Kang HJ, Chang HM, Kim TW, et al.PhaseⅡstudy of capecitabine and cisplatin as first-line combination therapy in patients with gastric cancer recurrent after fluoropyrimidine-based adjuvant chemotherapy.Br J Cancer, 2005, 92(2):246-251.
19. Blakely AM, Miner TJ.Surgical considerations in the treatment of gastric cancer.Gastroenterol Clin North Am, 2013, 42(2):337-357.
20. Shin D, Park SS.Clinical importance and surgical decision-making regarding proximal resection margin for gastric cancer.World J Gastrointest Oncol, 2013, 5(1):4-11.
21. Yoo CH, Noh SH, Shin DW, et al.Recurrence following curative resection for gastric carcinoma.Br J Surg, 2000, 87(3):236-242.
22. D'Angelica M, Gonen M, Brennan MF, et al.Patterns of initial recurrence in completely resected gastric adenocarcinoma.Ann Surg, 2004, 240(5):808-816.
23. Nakajima T, Ota K, Ishihara S, et al.Combined intensive chemo-therapy and radical surgery for incurable gastric cancer.Ann Surg Oncol, 1997, 4(3):203-208.
24. Wilke H, Preusser P, Fink U, et al.Preoperative chemotherapy in locally advanced and nonresectable gastric cancer:a phase II study with etoposide, doxorubicin, and cisplatin.J Clin Oncol, 1989, 7(9):1318-1326.
25. Wilke H, Stahl M, Fink U, et al.Preoperative chemotherapy for unresectable gastric cancer.World J Surg, 1995, 19(2):210-215.
26. Cascinu S, Scartozzi M, Labianca R, et al.High curative resection rate with weekly cisplatin, 5-fluorouracil, epidoxorubicin, 6S-leucovorin, glutathione, and filgastrim in patients with locally advanced, unresectable gastric cancer:a report from the Italian Group for the Study of Digestive Tract Cancer (GISCAD).Br J Cancer, 2004, 90(8):1521-1525.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis on Effect of Neoadjuvant Chemotherapy of Different Differentiated Grades of Locally Advanced Gastric Cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content