Three Cases of Advanced Gastric Cancer Confirmed as pathological Complete Response following Neoadjuvant Chemotherapy and Gastric Resection

Abstract

Neoadjuvant chemotherapy (NAC) is considered to be effective to improve the outcomes in patients with advanced gastric cancer. We encountered three patients who were confirmed as showing pathological complete response (pCR) following gastrectomy after NAC. Two patients had clinical stage III gastric cancer, while the third had clinical stage II gastric cancer. The first two patients received NAC with four courses of paclitaxel plus cisplatin while the third patient received four courses of S-1 plus cisplatin. All of the patients were treated by D2 gastrectomy after the NAC, and remain alive without recurrence. While several phase II/III clinical trials of gastric resection after NAC for advanced gastric cancer have reported pCR rates of around 2%, we obtained a pCR rate of as high as 20% (3/15) in our series. This difference might conceivably be explained by the difference in the number of NAC cycles. Therefore determination of the optimal number of NAC cycles may be needed to obtain an optimal pCR rate and further improvement of the outcome.