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
- Subjects
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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