1. Salvage gastrectomy following a combination of biweekly paclitaxel and S-1 for stage IV gastric cancer.
- Author
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Ishigami, Sumiya, Natsugoe, Shoji, Nakajo, Akihiro, Matsumoto, Masataka, Uenosono, Yoshikazu, Arigami, Takaaki, Setoyama, Tetsuro, Arima, Hideo, Uchikado, Yasuto, Kita, Yoshiaki, Sasaki, Ken, and Aikou, Takashi
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GASTRECTOMY , *STOMACH cancer , *PACLITAXEL , *ANTINEOPLASTIC agents , *CANCER chemotherapy , *ANTIMETABOLITES , *COMBINATION drug therapy , *COMPARATIVE studies , *DRUG administration , *FLUOROURACIL , *HETEROCYCLIC compounds , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *STOMACH tumors , *TIME , *TUMOR classification , *EVALUATION research , *TREATMENT effectiveness , *SALVAGE therapy - Abstract
Background and Aim: We investigated the clinical benefits of salvage gastrectomy for stage IV gastric cancer patients whose distant lesions showed complete response after chemotherapy.Methods: We enrolled 18 stage IV gastric cancer patients whose distant metastases had disappeared or were controlled by a combination of biweekly paclitaxel (PTX) and S-1. After chemotherapy, these patients received gastrectomy with lymph node dissection. The postoperative outcome was analyzed with respect to both the histological effects of chemotherapy and tumor behavior.Results: Of the 18 patients, 8 had distant lymph node metastases, 9 had peritoneal dissemination, and five had multiple liver metastases prior to chemotherapy. Fourteen patients received curative surgery (R0). No severe postoperative complications were encountered. Pathological evaluation revealed grade 3 and grade 2 tumor regression in the primary lesion in one and five patients, respectively, and grade 3 and grade 2 tumor regression in the lymph nodes in one and six patients, respectively. Univariate analysis of the patients' prognosis identified R number, gross tumor type, histological grade of tumor regression, and gender as significant factors. Multivariate analysis showed that only the R number was an independent prognostic factor.Conclusion: R0 salvage gastrectomy following a combination of biweekly PTX and S-1 may have significant clinical efficacy for advanced gastric cancer patients. [ABSTRACT FROM AUTHOR]- Published
- 2008
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