Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지

The Role of Preoperative Chemotherapy in Patients with Inoperable Metastatic or Locally Advanced Gastric Cancer

수술이 불가능한 전이성 또는 국소 진행성 위암 환자에서 선행화학요법의 효과

  • Chung Yoo-Seung (Departments of Surgery Seoul National University College of Medicine) ;
  • Park Do Joong (Departments of Surgery and Cancer Research Institute Seoul National University College of Medicine) ;
  • Lee Hyuk-Joon (Departments of Surgery and Cancer Research Institute Seoul National University College of Medicine) ;
  • Kim Se Hyung (Departments of Radiology, Seoul National University College of Medicine) ;
  • Han Joon Koo (Departments of Radiology, Seoul National University College of Medicine) ;
  • Kim Tae-You (Departments of Internal Medicine, and Cancer Research Institute, Seoul National University College of Medicine) ;
  • Bang Yung-Jue (Departments of Internal Medicine, and Cancer Research Institute, Seoul National University College of Medicine) ;
  • Heo Dae Seog (Departments of Internal Medicine, and Cancer Research Institute, Seoul National University College of Medicine) ;
  • Kim No Kyung (Departments of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim Woo Ho (Departments of Pathology, and Cancer Research Institute, Seoul National University College of Medicine) ;
  • Yang Han-Kwang (Departments of Surgery and Cancer Research Institute Seoul National University College of Medicine) ;
  • Lee Kuhn Uk (Departments of Surgery Seoul National University College of Medicine) ;
  • Choe Kuk Jin (Departments of Surgery Seoul National University College of Medicine)
  • 정유승 (서울대학교 의과대학 외과학교실) ;
  • 박도중 (서울대학교 의과대학 외과학교실 암연구소) ;
  • 이혁준 (서울대학교 의과대학 외과학교실 암연구소) ;
  • 김세형 (서울대학교 의과대학 진단방사선교실) ;
  • 한준구 (서울대학교 의과대학 진단방사선교실) ;
  • 김태유 (서울대학교 의과대학 내과학교실 암연구소) ;
  • 방영주 (서울대학교 의과대학 내과학교실 암연구소) ;
  • 허대석 (서울대학교 의과대학 내과학교실 암연구소) ;
  • 김노경 (서울대학교 의과대학 내과학교실) ;
  • 김우호 (서울대학교 의과대학 병리학교실 암연구소) ;
  • 양한광 (서울대학교 의과대학 외과학교실 암연구소) ;
  • 이건욱 (서울대학교 의과대학 외과학교실) ;
  • 최국진 (서울대학교 의과대학 외과학교실)
  • Published : 2004.03.01
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Abstract

Purpose: The purpose of this study was to evaluate the treatment result of surgical resection after preoperative chemotherapy in inoperable gastric cancer patients. Materials and Methods: We analyzed 18 gastric cancer patients who underwent gastric resection after preoperative chemotherapy because they showed some clinical response to chemotherapy (15 with distant metastasis and 3 with locally advanced lesions). The mean postoperative follow-up period was $15.3\pm15.5$ ($1\∼56$) months. Results: In 15 patients with distant metastasis, 2 ($13.3\%$) showed complete response (CR), 10 ($66.7\%$) partial response (PR), 2 ($13.3\%$) stable disease (SD), and 1 ($6.7\%$) progressive disease (PD). The clinical response rate was $80.0\%$ Five subtotal gastrectomies, 4 total gastrectomies, and 6 extended total gastrectomies were performed. Two cases of CR were alive without recurrence for 4 and 26 months, respectively. Mean survival period in PR case was 37.7 months, but 2 cases of SD and 1 case of PD died after 11.7, 17.9, and 0.9 months, respectively. Postoperative survival was significantly associated with the response to chemotherapy (P<0.01). The mean survival period of the 10 patients with a complete resection was 44.1 months, which was significantly better than that of the 5 patients with an incomplete resection (9.8 months, P=0.03). Among 3 patients with locally advanced gastric cancer, 2 cases showed PR to chemotherapy, and complete resection was possible only by gastrectomy for those patients. Conclusion: In some selected cases, surgical resection was achievable after preoperative chemotherapy for patients with inoperable metastatic or locally advanced gastric cancer.

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