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Impact of neoadjuvant chemotherapy on surgical and pathological results of gastric cancer patients: A case‐control study
Author(s) -
Charruf Amir Zeide,
Ramos Marcus Fernando Kodama Pertille,
Pereira Marina Alessandra,
Dias Andre Roncon,
Castria Tiago Biachi,
Zilberstein Bruno,
Cecconelo Ivan,
Ribeiro Ulysses
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25839
Subject(s) - medicine , gastrectomy , surgery , chemotherapy , lymphadenectomy , cancer , pathological , stage (stratigraphy) , neoadjuvant therapy , gastroenterology , breast cancer , paleontology , biology
Background and Objective Neoadjuvant chemotherapy (NACT) followed by radical surgery represents a treatment option for patients with advanced gastric cancer (GC). This case‐control study aimed to evaluate the clinicopathological characteristics and surgical outcomes of GC patients who received NACT, and its impact on survival. Methods We retrospectively reviewed all patients with GC who underwent gastrectomy. A total of 45 cases with NACT were matched with consecutive 45 patients who underwent upfront gastrectomy for the following characteristics: gender, age, gastrectomy type, lymphadenectomy extent, American Society of Anesthesiologists class, histological type, cT and cN. Results NACT group had smaller tumors (4.9 vs 6.8 cm P = .006), lower lymphatic invasion rate (40% vs 73.3%, P = .001), lower venous invasion rate (18% vs 46.7%, P = .003) and lower perineural invasion rate (35% vs 77.8%, P < .0001). The ypTNM stage was lower in patients treated with NACT ( P < .001). The major postoperative complication (POC) rate was lower in NACT patients (6.7% vs 24.4%, P = .02), as was hospital length of stay (10.8 vs 17 days, P = .005). Conclusions NACT allowed nodal and tumor downstaging. In addition, patients who underwent NACT had fewer POC and shorter length of hospital stay.