MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION
ABSTRACT BACKGROUND: Gastric cancer is an aggressive neoplasm with a poor prognosis. The multimodal approach with perioperative chemotherapy is currently the recommended treatment for patients with locally advanced gastric cancer. This treatment induces a histopathological response expressed either...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2023-01-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100342&tlng=en |
| _version_ | 1797951390657544192 |
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| author | Maria Cecília de Aguiar MACHADO José Pedro Coimbra de Vargas Lobarinhas BARBOSA Filipa Ferreira de OLIVEIRA José Adelino Lobarinhas BARBOSA |
| author_facet | Maria Cecília de Aguiar MACHADO José Pedro Coimbra de Vargas Lobarinhas BARBOSA Filipa Ferreira de OLIVEIRA José Adelino Lobarinhas BARBOSA |
| author_sort | Maria Cecília de Aguiar MACHADO |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Gastric cancer is an aggressive neoplasm with a poor prognosis. The multimodal approach with perioperative chemotherapy is currently the recommended treatment for patients with locally advanced gastric cancer. This treatment induces a histopathological response expressed either through the degree of regression of the primary tumor or of the lymph nodes or through yTNM staging. Despite its advantages, there are still doubts regarding the effects of chemotherapy on postoperative morbidity and mortality. AIMS: This study aims to evaluate the impact of perioperative chemotherapy and its effect on anatomopathological results and postoperative morbidity and on patient survival. METHODS: This is an observational retrospective study on 134 patients with advanced gastric cancer who underwent perioperative chemotherapy and curative radical surgery. The degree of histological regression of the primary tumor was evaluated according to Becker’s criteria; the proportion of regressed lymph nodes was determined, and postoperative complications were evaluated according to the Clavien-Dindo classification. Survival times were compared between the groups using Kaplan-Meier curves and the Mantel-Cox log-rank test. RESULTS: In all, 22.3% of the patients were classified as good responders and 75.9% as poor responders. This variable was not correlated with operative morbidity (p=1.68); 64.2% of patients had invaded lymph nodes and 46.3% had regressed lymph nodes; and 49.4% had no lymphatic invasion and 61.9% had no signs of venous invasion. Postoperative complications occurred in 30.6% of the patients. The group of good responders had an average survival of 56.0 months and the group of poor responders had 34.0 months (p=0.17). CONCLUSION: Perioperative chemotherapy induces regression in both the primary tumor and lymph nodes. The results of the operative morbidity were similar to those described in the literature. However, although the group of good responders showed better survival, this value was not significant. Therefore, further studies are needed to evaluate the importance of the degree of lymph node regression and its impact on the survival of these patients. |
| first_indexed | 2024-04-10T22:29:52Z |
| format | Article |
| id | doaj.art-9d1d33b1591a4e79a6af1cccafb2e8cc |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-04-10T22:29:52Z |
| publishDate | 2023-01-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-9d1d33b1591a4e79a6af1cccafb2e8cc2023-01-17T07:31:14ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202023-01-013510.1590/0102-672020220002e1704MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSIONMaria Cecília de Aguiar MACHADOhttps://orcid.org/0000-0001-9901-5947José Pedro Coimbra de Vargas Lobarinhas BARBOSAhttps://orcid.org/0000-0002-5994-6189Filipa Ferreira de OLIVEIRAhttps://orcid.org/0000-0003-2891-7008José Adelino Lobarinhas BARBOSAhttps://orcid.org/0000-0002-6005-5383ABSTRACT BACKGROUND: Gastric cancer is an aggressive neoplasm with a poor prognosis. The multimodal approach with perioperative chemotherapy is currently the recommended treatment for patients with locally advanced gastric cancer. This treatment induces a histopathological response expressed either through the degree of regression of the primary tumor or of the lymph nodes or through yTNM staging. Despite its advantages, there are still doubts regarding the effects of chemotherapy on postoperative morbidity and mortality. AIMS: This study aims to evaluate the impact of perioperative chemotherapy and its effect on anatomopathological results and postoperative morbidity and on patient survival. METHODS: This is an observational retrospective study on 134 patients with advanced gastric cancer who underwent perioperative chemotherapy and curative radical surgery. The degree of histological regression of the primary tumor was evaluated according to Becker’s criteria; the proportion of regressed lymph nodes was determined, and postoperative complications were evaluated according to the Clavien-Dindo classification. Survival times were compared between the groups using Kaplan-Meier curves and the Mantel-Cox log-rank test. RESULTS: In all, 22.3% of the patients were classified as good responders and 75.9% as poor responders. This variable was not correlated with operative morbidity (p=1.68); 64.2% of patients had invaded lymph nodes and 46.3% had regressed lymph nodes; and 49.4% had no lymphatic invasion and 61.9% had no signs of venous invasion. Postoperative complications occurred in 30.6% of the patients. The group of good responders had an average survival of 56.0 months and the group of poor responders had 34.0 months (p=0.17). CONCLUSION: Perioperative chemotherapy induces regression in both the primary tumor and lymph nodes. The results of the operative morbidity were similar to those described in the literature. However, although the group of good responders showed better survival, this value was not significant. Therefore, further studies are needed to evaluate the importance of the degree of lymph node regression and its impact on the survival of these patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100342&tlng=enStomach NeoplasmsDrug TherapyLymph NodesPostoperative ComplicationsSurvival |
| spellingShingle | Maria Cecília de Aguiar MACHADO José Pedro Coimbra de Vargas Lobarinhas BARBOSA Filipa Ferreira de OLIVEIRA José Adelino Lobarinhas BARBOSA MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION ABCD: Arquivos Brasileiros de Cirurgia Digestiva Stomach Neoplasms Drug Therapy Lymph Nodes Postoperative Complications Survival |
| title | MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION |
| title_full | MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION |
| title_fullStr | MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION |
| title_full_unstemmed | MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION |
| title_short | MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION |
| title_sort | morbidity and survival after perioperative chemotherapy in gastric cancer a study using the becker s classification and regression |
| topic | Stomach Neoplasms Drug Therapy Lymph Nodes Postoperative Complications Survival |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100342&tlng=en |
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