ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER?
ABSTRACT Background: The treatment of advanced gastric cancer with curative intent is essentially surgical and chemoradiotherapy is indicated as neo or adjuvant to control the disease and prolong survival. Aim: To assess the survival of patients undergoing subtotal or total gastrectomy with D2 lym...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2019-12-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202019000400303&tlng=en |
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| author | Nelson Adami ANDREOLLO Eric DRIZLIONOKS Valdir TERCIOTI-JUNIOR João de Souza COELHO-NETO José Antonio Possato FERRER José Barreto Campello CARVALHEIRA Luiz Roberto LOPES |
| author_facet | Nelson Adami ANDREOLLO Eric DRIZLIONOKS Valdir TERCIOTI-JUNIOR João de Souza COELHO-NETO José Antonio Possato FERRER José Barreto Campello CARVALHEIRA Luiz Roberto LOPES |
| author_sort | Nelson Adami ANDREOLLO |
| collection | DOAJ |
| description | ABSTRACT Background: The treatment of advanced gastric cancer with curative intent is essentially surgical and chemoradiotherapy is indicated as neo or adjuvant to control the disease and prolong survival. Aim: To assess the survival of patients undergoing subtotal or total gastrectomy with D2 lymphadenectomy followed by adjuvant chemoradiotherapy. Methods: Were retrospectively analyzed 87 gastrectomized patients with advanced gastric adenocarcinoma, considered stages IB to IIIC and submitted to adjuvant chemoradiotherapy (protocol INT 0116). Tumors of the esophagogastric junction, with peritoneal implants, distant metastases, and those that had a compromised surgical margin or early death after surgery were excluded. They were separated according to the extention of the gastrectomy and analyzed for tumor site and histopathology, lymph node invasion, staging, morbidity and survival. Results: The total number of patients who successfully completed the adjuvant treatment was 45 (51.7%). Those who started treatment and discontinued due to toxicity, tumor-related worsening, or loss of follow-up were 10 (11.5%) and reported as incomplete adjuvant. The number of patients who refused or did not start adjuvant treatment was 33 (48.3%). Subtotal gastrectomy was indicated in 60 (68.9%) and total in 27 (31.1%) and this had a shorter survival. The mean resected lymph nodes was 30.8. Staging and number of lymph nodes affected were predictors of worse survival and the more advanced the tumor. Patients undergoing adjuvant therapy with complete chemoradiotherapy showed a longer survival when compared to those who did it incompletely or underwent exclusive surgery. On the other hand, comparing the T4b (IIIB + IIIC) staging patients who had complete adjuvance with those who underwent the exclusive operation or who did not complete the adjuvant, there was a significant difference in survival. Conclusion: Adjuvant chemoradiotherapy presents survival gain for T4b patients undergoing surgical treatment with curative intent. |
| first_indexed | 2024-12-20T09:33:22Z |
| format | Article |
| id | doaj.art-8a8a98f28d27429881fb7ab9bf1642ea |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-12-20T09:33:22Z |
| publishDate | 2019-12-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-8a8a98f28d27429881fb7ab9bf1642ea2022-12-21T19:45:02ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202019-12-0132410.1590/0102-672020190001e1464ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER?Nelson Adami ANDREOLLOhttps://orcid.org/0000-0001-7452-1165Eric DRIZLIONOKShttps://orcid.org/0000-0001-7176-0670Valdir TERCIOTI-JUNIORhttps://orcid.org/0000-0003-0510-7360João de Souza COELHO-NETOhttps://orcid.org/0000-0001-7415-1635José Antonio Possato FERRERhttps://orcid.org/0000-0002-4498-6786José Barreto Campello CARVALHEIRAhttps://orcid.org/0000-0002-0136-0943Luiz Roberto LOPEShttps://orcid.org/0000-0002-8996-6658ABSTRACT Background: The treatment of advanced gastric cancer with curative intent is essentially surgical and chemoradiotherapy is indicated as neo or adjuvant to control the disease and prolong survival. Aim: To assess the survival of patients undergoing subtotal or total gastrectomy with D2 lymphadenectomy followed by adjuvant chemoradiotherapy. Methods: Were retrospectively analyzed 87 gastrectomized patients with advanced gastric adenocarcinoma, considered stages IB to IIIC and submitted to adjuvant chemoradiotherapy (protocol INT 0116). Tumors of the esophagogastric junction, with peritoneal implants, distant metastases, and those that had a compromised surgical margin or early death after surgery were excluded. They were separated according to the extention of the gastrectomy and analyzed for tumor site and histopathology, lymph node invasion, staging, morbidity and survival. Results: The total number of patients who successfully completed the adjuvant treatment was 45 (51.7%). Those who started treatment and discontinued due to toxicity, tumor-related worsening, or loss of follow-up were 10 (11.5%) and reported as incomplete adjuvant. The number of patients who refused or did not start adjuvant treatment was 33 (48.3%). Subtotal gastrectomy was indicated in 60 (68.9%) and total in 27 (31.1%) and this had a shorter survival. The mean resected lymph nodes was 30.8. Staging and number of lymph nodes affected were predictors of worse survival and the more advanced the tumor. Patients undergoing adjuvant therapy with complete chemoradiotherapy showed a longer survival when compared to those who did it incompletely or underwent exclusive surgery. On the other hand, comparing the T4b (IIIB + IIIC) staging patients who had complete adjuvance with those who underwent the exclusive operation or who did not complete the adjuvant, there was a significant difference in survival. Conclusion: Adjuvant chemoradiotherapy presents survival gain for T4b patients undergoing surgical treatment with curative intent.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202019000400303&tlng=enGastric neoplasmAdjuvant therapyGastrectomy |
| spellingShingle | Nelson Adami ANDREOLLO Eric DRIZLIONOKS Valdir TERCIOTI-JUNIOR João de Souza COELHO-NETO José Antonio Possato FERRER José Barreto Campello CARVALHEIRA Luiz Roberto LOPES ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER? ABCD: Arquivos Brasileiros de Cirurgia Digestiva Gastric neoplasm Adjuvant therapy Gastrectomy |
| title | ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER? |
| title_full | ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER? |
| title_fullStr | ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER? |
| title_full_unstemmed | ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER? |
| title_short | ADJUVANT CHEMORADIOTHERAPY AFTER SUBTOTAL OR TOTAL GASTRECTOMY AND D2 LIMPHADENECTOMY INCREASES SURVIVAL IN ADVANCED GASTRIC CANCER? |
| title_sort | adjuvant chemoradiotherapy after subtotal or total gastrectomy and d2 limphadenectomy increases survival in advanced gastric cancer |
| topic | Gastric neoplasm Adjuvant therapy Gastrectomy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202019000400303&tlng=en |
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