The Impact of Preoperative Chemotherapy on the Surgical Management of Unresectable Gastric Cancer

ABSTRACT

PURPOSE: There have been reported that preoperative chemotherapy for treating noncurative gastric cancer could increase the R0 resection rate by downstaging the gastric cancer. Yet there have been only rare reports about the effect of preoperative chemotherapy on performing surgery for noncurative gastric cancer. Our study was designed to analyze our experiences with these effects. MATERIALS AND METHODS: We retrospectively analyzed 46 patients who had undergone gastrectomy after chemotherapy between December 2001 and January 2009. The patients' preoperative condition, the operative findings and the postoperative clinical coursed were analyzed. RESULTS: Preoperative chemotherapy was performed for a mean of 4.4 cycles. Four patients showed a level of ANC below 1,500 (micron/L) and above a 10 percentile weight loss, respectively. For an operation, we found fibrosis or fixation between the tumor and the adjacent organs in 29 patients, and 4 of the 13 patients who underwent resection with another organ were documented to have invasion by tumor. Forty one patients underwent curative resection. Ten patients developed postoperative complications. There was no mortality at postoperative 60 days. CONCLUSION: We assumed that preoperative chemotherapy had little effect on the patient preoperatively, and it had some effect on down-staging pathologically. Preoperative chemotherapy didn't increase the postoperative complication rate.