Prospective Randomized Controlled Study Comparing Primary Surgery Versus Neoadjuvant Chemotherapy Followed by Surgery...

Area of Science:

• Surgical Oncology
• Gastroenterology
• Medical Oncology

Background:

• Neoadjuvant chemotherapy enhances resectability and treats micrometastatic disease in gastric cancer.
• Comparing upfront surgery with neoadjuvant chemotherapy followed by surgery is crucial for optimizing gastric adenocarcinoma treatment.

Purpose of the Study:

• To compare resectability and R0 resection rates between upfront surgery and neoadjuvant chemotherapy followed by surgery.
• To evaluate the safety and tolerability of neoadjuvant chemotherapy by assessing postoperative morbidity and mortality.

Main Methods:

• A randomized trial involving 60 gastric adenocarcinoma patients.
• Patients were assigned to either primary surgery or neoadjuvant chemotherapy followed by surgery.
• Data on morbidity, mortality, and pathological status were collected and analyzed.

Main Results:

• Operating times were comparable between the primary surgery (290 min) and neoadjuvant chemotherapy arms (316.7 min).
• No significant differences were observed in postoperative complications, differentiated histology, T stage, lymph node harvest, R0 resection, PNI, or LVI between the groups.
• Neoadjuvant chemotherapy demonstrated a trend towards improved R0 resection rates.

Conclusions:

• Neoadjuvant chemotherapy is well-tolerated in gastric cancer patients, with no significant increase in postoperative morbidity or mortality.
• While not statistically significant, neoadjuvant chemotherapy shows a trend towards improving R0 resection rates, warranting further investigation.