[Adjuvant surgery for advanced gastric cancer]

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Advanced gastric cancer presents significant treatment challenges.
• Chemotherapy response is a critical factor in treatment planning.
• The role of surgery after chemotherapy requires further investigation.

Purpose of the Study:

• To assess the effectiveness of adjuvant surgery after chemotherapy in advanced gastric cancer patients.
• To determine survival outcomes in patients undergoing surgery post-chemotherapy.
• To identify patient subgroups who may benefit most from this combined approach.

Main Methods:

• A cohort of 20 advanced gastric cancer patients received combination chemotherapy (docetaxel and S-1) followed by gastrectomy.
• The chemotherapy regimen involved S-1 (80 mg/m2) for 14 days with a 7-day rest, and docetaxel (40 mg/m2) on day 1.
• Data collected included treatment response, overall survival, and survival based on metastasis status.

Main Results:

• The median overall survival was 855 days, with 2-year and 3-year survival rates of 80% and 54.9% respectively, in patients who underwent macroscopically curative operations.
• Seventeen patients achieved a partial response (PR) and three had stable disease (SD).
• Median survival differed significantly between patients with liver metastasis (865 days) and peritoneal dissemination (510 days).

Conclusions:

• Adjuvant surgery appears effective for advanced gastric cancer patients who respond well to neoadjuvant chemotherapy.
• Peritoneal dissemination is a contraindication for adjuvant surgery in this patient group.
• Further research is warranted to optimize treatment strategies for advanced gastric cancer.