Neoadjuvant Chemotherapy with CPT-11 and Cisplatin Downstages Locally Advanced Gastric Cancer

Newman, Elliot; Marcus, Stuart G.; Potměšil, Milan; Sewak, Sanjeev; Yee, Herman; Sorich, Joan; Hayek, M; Muggia, Franco M.; Hochster, Howard S.

doi:10.1016/s1091-255x(01)00054-3

Cited by 33 publications

(18 citation statements)

References 31 publications

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“…Postoperative morbidity after gastric cancer resection ranges between 7.7% [35] and 57.9% [45] , and mortality between 0.0% [25,34,[46][47][48] up to 13.0% [49] . It should be noted that there is, in general, a problem in the comparability of postoperative morbidity of different studies: the criteria of postoperative morbidity either were not outlined [5,6,25,[49][50][51][52][53][54] or different criteria were included [15-20, 34, 35, 45, 46, 55-61] .…”

Section: Discussionmentioning

confidence: 99%

Impact of Neoadjuvant Chemotherapy on Postoperative Morbidity after Gastrectomy for Gastric Cancer

Téoule

Trojan²,

Bechstein³

et al. 2015

Dig Surg

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Background/Aims: Patients with locally advanced gastric cancer benefit from neoadjuvant chemotherapy. Potential disadvantages of neoadjuvant chemotherapy include increased surgical complications, leading to increased postoperative morbidity. Methods: We retrospectively studied medical records of 135 patients with resectable cancer of the stomach who underwent gastrectomy between 2002 and 2009. The impact of neoadjuvant chemotherapy on postoperative morbidity was investigated. We compared demographic, clinical and operative data, morbidity and mortality from 105 patients who received surgical treatment immediately after diagnosis (SURG group), versus 30 patients who first received neoadjuvant chemotherapy (CHEMO group). Results: Demographic, clinical and surgical procedure parameters did not differ significantly between both groups. Postoperative morbidity was 46.7% in CHEMO- and 41.9% in SURG-patients (p = 0.680). There were eight cases of death, 2/30 (6.7%) in CHEMO and 6/105 (5.7%) in the SURG group (p = 1). The overall complications according to Clavien-classification did not differ significantly (p = 0.455). The wound infection rate (23.3 vs. 3.8%; p = 0.002) and insufficiency of the duodenal stump (13.3 vs. 1.9%; p = 0.022) were significantly higher in the CHEMO group. Conclusion: This study showed no significant impact of neoadjuvant chemotherapy on postoperative morbidity after gastrectomy using the Clavien-classification. Only an increase in wound infections in CHEMO compared with the SURG group were noted. Therefore, neoadjuvant chemotherapy can be considered safe and feasible.

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Section: Discussionmentioning

confidence: 99%

Impact of Neoadjuvant Chemotherapy on Postoperative Morbidity after Gastrectomy for Gastric Cancer

Téoule

Trojan²,

Bechstein³

et al. 2015

Dig Surg

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“…An updated report with more patients and longer follow-up was recently published by this group with a median survival of 52 months [17]. As outlined in Table II, other groups have achieved similar results with preoperative cisplatin-based chemotherapy and postoperative IP chemotherapy [21]. Other regimens such as 5-FU, doxorubicin, and methotrexate (FAMTX) have been less encouraging and more toxic [22].…”

Section: Clinical Trials Of Neoadjuvant Therapy Phases I-ii Trialsmentioning

confidence: 93%

Neoadjuvant therapy of locally advanced gastric cancer

Mezhir

Tang

Coit

2010

Journal of Surgical Oncology

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Treatment of gastric cancer has evolved with the advent of randomized trials demonstrating chemotherapeutic agents with efficacy in advanced disease. Level I evidence supports delivering chemotherapy in the neoadjuvant setting; the data shows improvement in progression-free and overall survival. A clinical response to therapy is associated with improved R0 resection rates, pathologic response, and outcome in patients with locally advanced disease. Early assessment of metabolic response to therapy can potentially be utilized to tailor treatment.

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“…Moreover, destruction of free circulating cells could be more effective before surgery, because of often delayed postoperative chemotherapy due to complicated postoperative courses. This signifi cant prognostic advantage seems to be reached with the results published by Newman et al [17] in 2002 in a trial with only 22 patients; 19 could undergo surgery with 18 R0 resec-tions. Understaging was effective with 16% pT3 after chemotherapy versus 85% uT3 preoperatively, and 37% stage IIIA versus 70% before treatment.…”

Section: Preoperative Chemotherapymentioning

confidence: 89%

Treatment of Peritoneal Carcinomatosis in Gastric Cancers

Brigand

Arvieux

Gilly

et al. 2004

Dig Dis

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Peritoneal carcinomatosis may occur after curative surgery of any gastrointestinal carcinoma, but it is however the most frequent form of evolution after curative resection of gastric carcinoma and is present at the time of surgery in many cases. This locoregional extension of cancer has a poor prognosis, with a great mortality and a poor quality of life. It is sometimes considered of such a poor prognosis that patients do not go through any resection or palliative procedure. Techniques of radiotherapy, chemotherapy and intraperitoneal chemotherapy have been used with moderate clinical efficacy. Since the 1990s, intraoperative hyperthermic peritoneal chemotherapy combined with comprehensive cytoreductive surgery has been proposed to improve prognosis of patients with peritoneal carcinomatosis from gastric origin as well as carcinomatosis from colorectal origin or pseudomyxoma peritonei.

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Neoadjuvant Chemotherapy with CPT-11 and Cisplatin Downstages Locally Advanced Gastric Cancer

Cited by 33 publications

References 31 publications

Impact of Neoadjuvant Chemotherapy on Postoperative Morbidity after Gastrectomy for Gastric Cancer

Impact of Neoadjuvant Chemotherapy on Postoperative Morbidity after Gastrectomy for Gastric Cancer

Neoadjuvant therapy of locally advanced gastric cancer

Treatment of Peritoneal Carcinomatosis in Gastric Cancers

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