P-074 - Clinical outcome of doublet and triplet neoadjuvant chemotherapy for marginally and potentially resectable gastric cancer. retrospective single cent...

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Presenter J.S. Kim
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors J.S. Kim, H.S. Moon, S.H. Kang, J.K. Sung, H.Y. Jeong
  • Chungnam National University School of Medicine, Daejeon/KR

Abstract

Introduction

Gastric cancer is the fourth most common malignancy in the world, and the second leading cause of cancer-related deaths and the highest mortality rates are reported in East Asia. Early detection and surgery are currently considered the mainstay of treatment, and approximately half of gastric cancer patients can be treated by curative surgical or endoscopic resection. However, the rate of recurrence and metastasis following radical resection remains disappointingly high. Thus, improving the rates of survival and cure is a critical goal.

Methods

We retrospective reviewed the patient medical record. This study enrolled 179 patients who underwent NAC followed by surgery (n = 41) or surgery only (n = 138) for treatment of stage IIIa or IIIb locally advanced gastric cancer. For sampling, we applied a random sample extraction method. We categorized the NAC group and the Surgery only group according to gender and age then, we applied a serial number to each category. We were using two chemo- regimens FOLFOX (n = 28) and DCF (n = 13). The basal characteristics and clinical outcome were compared between two groups. NAC related objective response, safety and toxicity were also analyzed.

Results

The basal characteristics including mean age and sex was not significant difference between two groups. Initial stage was significantly high (P = 0.001) in NAC followed by surgery (3.12 0.56) than surgery only group (2.57 0.54). After NAC, the tumor down-stage rate was 58.5% (24/41). Both tumor size and differentiation were predictive factor of resistance to NAC. But overall survival (P = 0.518), disease free survival (P = 0.621) and recurrence rate (P = 0.142) were not statistically difference between two groups. In subgroup analysis we compared clinical outcome between doublet (n = 28) and triplet (n = 13) NAC group. As a result, age, sex, tumor down stage rate and recurrence were similar between two groups. But drug toxicity (P = 0.019) and initial stage (P = 0.010) were significant higher in triplet NAC than doublet NAC group.

Conclusion

Compared with surgery only versus NAC followed by surgery was not associated with a survival gain or lower recurrence rate. However, down of N stage is significantly improved statistically. In our data, tumor size and differentiation was the important clinical predictor. Therefore NAC may be benefit for selective treatment option and assessing individual prognosis.