A pilot study of an individualized comprehensive treatment for advanced gastric cancer with para-aortic lymph node metastasis

BMC Gastroenterology
Qi HeGuoli Li

Abstract

The incidence of the para-aortic lymph node metastasis (PALM) in patients with advanced gastric cancer is 6 to 33 %. The prognosis is poor and the 5-year survival rate is only 12 to 23 % after gastrectomy with super-extended lymph node dissection. We applied an individualized comprehensive treatment for affected patients including neoadjuvant chemotherapy via intra-arterial and intravenous administration, surgery and radiotherapy, to investigate the safety and prognostic value. Between January 2005 and December 2010, 47 advanced gastric cancer patients with PALM received 5-Fu (370 mg/m(2)) and leucovorin (200 mg/m(2)) intravenously on days 1-5, and intra-arterial infusion of etoposide (80 mg/m(2)) and oxaliplatin (80 mg/m(2)) on days 6 and 20, repeated 2 cycles. Patients achieved PR or CR of the para-aortic lymph node (PAL) were performed D2 dissection, followed by 6 cycles chemotherapy with XELOX regimen, oxaliplatin (130 mg/m(2)) on day 1 and xeloda (1000 mg/m(2)) on days 1 to 14 of a 28-day cycle, and radiotherapy to the region of PALM. Forty-six patients completed 2 cycles of neoadjuvant chemotherapy. The overall response rate of the primary tumor was 80.4 % (37/46). The response rate of PAL was 76.1 % (35/46). Thirty-two p...Continue Reading

References

Dec 1, 1982·American Journal of Clinical Oncology·M M OkenP P Carbone
Sep 16, 2005·The New England Journal of Medicine·Jiang HePaul K Whelton
Jul 11, 2006·The New England Journal of Medicine·David Cunningham MAGIC Trial Participants
Jun 20, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Alberto Di LeoGiovanni de Manzoni
Nov 6, 2007·The New England Journal of Medicine·Shinichi SakuramotoUNKNOWN ACTS-GC Group
May 9, 2008·International Journal of Clinical Oncology·Yutaka YonemuraUNKNOWN East Asia Surgical Oncology Group
Nov 24, 2011·World Journal of Gastroenterology : WJG·Yingsong LinManami Inoue

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BETA
dissection
biopsy
X-ray

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SPSS

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