Cancer Research and Treatment

Original Article

The Effect of Adjuvant Chemotherapy on Stage IV (T4N1-3M0 and T1-3N3M0) Gastric Cancer: Tae Kyung Ha, Min Sung Jung, Kang Hong Lee, Kyeong Geun Lee, Sung Joon Kwon; Cancer Res Treat. 2009;41(1):19-23. Published online March 31, 2009; DOI: https://doi.org/10.4143/crt.2009.41.1.19

Purpose

The optimal chemotherapeutic strategy for gastric cancer patients has not been determined, especially with respect to stage and the curability of gastric cancer. The aim of this study was to evaluate the results of adjuvant chemotherapy on stage IV (T4N1-3M0 and T1-3N3M0) gastric cancer after curative gastrectomy between a chemotherapy (CTX) group and non-chemotherapy (non-CTX) group.

Materials and Methods

Among 1,760 patients who underwent gastric surgery by 1 surgeon in a single institution, 162 stage IV gastric cancer patients with curative gastrectomy were analyzed retrospectively, excluding patients with TanyNanyM1. One hundred twenty-five patients who received different chemotherapeutic regimens were compared to 37 patients who did not receive chemotherapy for reasons of old age or according to their expressed desire.

Results

The clinicopathologic factors which showed a clinically significant difference between the two groups were age and histology, which were not associated with patient survival. The CTX group was younger, and had a larger proportion of undifferentiated gastric cancers than the non-CTX group. The mode of treatment failure revealed no significant difference between the CTX and non-CTX groups. The 1, 3, and 5-year disease-free survival and the 1, 3, and 5-year disease-specific survival of the CTX group were 63.9%, 38.4%, and 32.0%, and 85.4%, 52.3%, and 39.6%, respectively, which were more favorable than the non-CTX group (p=0.015 and p=0.001, respectively). Postoperative adjuvant CTX was an independent risk factor for disease-specific survival of stage IV (T4N1-3M0 and T1-3N3M0) gastric cancer patients after curative gastrectomy by multivariate analysis (odds ratio=2.153; 95% confidence interval=1.349-3.435; p=0.001).

Conclusions

Adjuvant CTX may be associated with survival benefit for younger patients with stage IV (T4N1-3M0 and T1-3N3M0) gastric cancer with undifferentiated histology after curative gastrectomy. A randomized controlled trial to reveal the effect of stage-specific adjuvant chemotherapy should be conducted.

Citations

Citations to this article as recorded by

Impact of duration of adjuvant chemotherapy in radically resected patients with T4bN1-3M0/TxN3bM0 gastric cancer
Qi-Wei Wang, Xiao-Tian Zhang, Ming Lu, Lin Shen
World Journal of Gastrointestinal Oncology.2018; 10(1): 31. CrossRef
Adjuvant chemotherapy after curative resection for gastric cancer: a meta-analysis
Jisen Cao, Feng Qi, Tong Liu
Scandinavian Journal of Gastroenterology.2014; 49(6): 690. CrossRef

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Case Report

Isolated Diaphragmatic Metastasis Originated from Adenocarcinoma of the Colon: Kang Hong Lee, Chang Sik Yu, Hwan Namgung, Hee Cheol Kim, Jin Cheon Kim; Cancer Res Treat. 2004;36(2):157-159. Published online April 30, 2004; DOI: https://doi.org/10.4143/crt.2004.36.2.157

Abstract PDF PubReader ePub

Isolated diaphragmatic metastasis arising from colorectal cancer has been reported only one case in the literature presently. Here, we presented a new case and discussed the possible pathogenesis and the treatment options. A 42-year-old male patient had received anterior resection for sigmoid colon cancer. Although the increased serum CEA level was detected 20 months after the surgery, metastatic lesion could not be detected by repeated colonoscopy, CT scan, bone scan or PET scan for 35 months. We could detect a suspicious metastatic lesion on the liver by CT scan at 56 month after the surgery. During a second-look operation, we found a solitary metastasis on the diaphragm and removed it along with the 1 cm tumor-free resection margin. Although the prognosis associated with skeletal metastasis is poor, the complete resection of isolated diaphragmatic metastasis and subsequent appropriate adjuvant chemotherapy may achieve a cure the disease provided that other metastatic lesions are absent.

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Cláudia Rocha, Vera Clérigo, Lígia Fernandes, André Rodrigues, Dora Sargento, Glória Silva
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60 Download
6 Crossref

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