Downstaging of lymph node metastasis after neoadjuvant intraperitoneal and systemic chemotherapy in gastric carcinoma with peritoneal metastasis.

Abstract

PURPOSE:

The aim of the present study was to evaluate the clinical features and prognosis of lymph node metastasis (LNM) in gastric cancer patients with peritoneal metastasis (PM) after neoadjuvant intraperitoneal and systemic chemotherapy.

METHODS:

A total of 69 gastric cancer patients with PM and LNM who received neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) of intraperitoneal docetaxel (DXT) and cisplatin (CDDP); intravenous chemotherapy of DXT and CDDP and oral S-1in Kishiwada Tokushukai Hospital between January 2008 and February 2017. After surgical resection, the response of LNMs was studied to confirm the effect of NIPS on LNMs.

RESULTS:

After NIPS, 197 lymph nodes (LNs) (42.5%) were graded as G3, the progression in LNMs were significantly better than in the primary tumors. Until the last follow-up, 1-year overall survival rate was 82.6%, and the median survival period was 22.0 ± 3.7 months. In the group of patients who had achieved a more than 50% G3 grade of the response of LNMs, the median survival period is 38 months; in the less than 50% G3 grade group, it is 14 months, that is a significantly different result. Multivariate analyses showed that the factors PCI, Post-therapeutic N status and response of the LNMs were found to be as independent prognostic factors.

CONCLUSION:

Downstaging of LNMs were achieved in patients of gastric cancer with PM who received NIPS. Downstaging of LNMs after NIPS is related with the prognosis of gastric cancer and should be valued in subsequent surgery for gastric cancer with peritoneal and lymph nodes metastasis.

• Authors: Y Hao, Y Liu, H Ishibashi, S Wakama, E Nishino, Y Yonemura
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 45 Issue 8 Pg. 1493-1497 (Aug 2019) ISSN: 1532-2157 [Electronic] England
• PMID: 30948161 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Chemotherapy, Adjuvant
• Cohort Studies
• Databases, Factual
• Disease-Free Survival
• Female
• Gastrectomy (methods)
• Humans
• Infusions, Parenteral
• Japan
• Kaplan-Meier Estimate
• Lymph Node Excision (methods)
• Lymph Nodes (pathology, surgery)
• Lymphatic Metastasis (pathology)
• Male
• Middle Aged
• Multivariate Analysis
• Neoadjuvant Therapy (methods)
• Neoplasm Invasiveness (pathology)
• Peritoneal Neoplasms (mortality, secondary, therapy)
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Stomach Neoplasms (mortality, pathology, therapy)
• Survival Analysis