Downstaging of lymph node metastasis after neoadjuvant intraperitoneal and systemic chemotherapy in gastric carcinoma with peritoneal metastasis |
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| Affiliation: | 1. Department of General Surgery, Shanghai Jiaotong University School of Medicine Xinhua Hospital, China;2. NPO to Support Peritoneal Dissemination Treatment, Osaka, Japan;3. Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan;4. Department of Pathology, Kishiwada Tokushukai Hospital, Kishiwada, Japan;5. Department of Surgery, Kusatsu Genaral Hospital, Shiga, Japan;1. Department of General Surgery, Hospital Universitario de Araba (HUA) Sede Hospital Santiago, Spain;2. Universidad Del País Vasco (UPV), Vitoria, Spain;3. Hospital San José, Vitoria, Spain;1. Department of Visceral and Oncological Surgery, Gustave Roussy, Cancer Campus, 94805, Villejuif Cedex, France;2. Department of Interventional Radiology, Gustave Roussy, Cancer Campus, 94805, Villejuif Cedex, France;3. Department of Medical Oncology, Gustave Roussy, Cancer Campus, 94805, Villejuif, Cedex, France;1. Department of Molecular Medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden;2. Department of Medicine/Huddinge Karolinska Institutet and ANOVA, Karolinska University Hospital, Stockholm, Sweden;3. Surgical Clinic, Sergelkliniken, Stockholm, Sweden;4. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden;5. Function Promoting Therapies, Waltham, MA, USA;6. Research Program in Men''s Health: Aging and Metabolism, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, USA |
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| Abstract: | PurposeThe 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.MethodsA 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.ResultsAfter 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.ConclusionDownstaging 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. |
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| Keywords: | Gastric cancer Peritoneal metastasis Lymph node metastasis NIPS |
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