Prophylactic effect of neoadjuvant chemotherapy in gastric cancer patients with postoperative complications
Prophylactic effect of neoadjuvant chemotherapy in gastric cancer patients with postoperative complications
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DOI：
10.1007/s10120-017-0781-y
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发表时间：
2018-07-01
期刊：
影响因子：
7.4
通讯作者：
Yamaguchi, Toshiharu
中科院分区：
文献类型：
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作者：
Eto, Kojiro;Hiki, Naoki;Yamaguchi, Toshiharu
背景胃肠道肿瘤患者术后并发症的发生可能对其预后有显著的负面影响。炎症反应释放全身细胞因子，这可能会诱导残留的癌细胞生长。近年来，新辅助化疗（NAC）被发现可以改善晚期胃癌（GC）的预后。我们假设当胃切除术后出现术后并发症时，NAC治疗微转移灶可以防止残留癌细胞生长。方法本研究纳入2005 - 2015年101例胃癌NAC术后行根治性切除的患者。回顾性收集临床资料，包括术中参数。比较有并发症和无并发症患者的总生存期（OS）和无复发生存期（RFS）。结果101例患者中有35例（34.7%）出现2级及以上并发症。并发症组3年和5年OS分别为63.5%和58.2%，3年和5年RFS分别为41.7%和41.7%。无并发症组3年和5年OS分别为65.9%和56.3%，3年和5年RFS分别为51.1%和43.9%。有并发症与无并发症患者的预后无显著差异。结论我们的研究首次证明了NAC在消除根治性胃癌切除术后并发症导致的不良预后方面的潜力。
Background The occurrence of postoperative complications may have a significant negative impact on the prognosis of patients with gastrointestinal cancers. The inflammatory response releases systemic cytokines, which may induce residual cancer cell growth. Recently, neoadjuvant chemotherapy (NAC) was found to improve the prognosis of advanced gastric cancer (GC). We hypothesize that when postoperative complications occur after gastrectomy, NAC treatment of micrometastases can prevent residual cancer cell growth.Methods This study included 101 patients who underwent curative resection after NAC for GC from 2005 to 2015. Clinical data, including intraoperative parameters, were collected retrospectively. Overall survival (OS) and relapse-free survival (RFS) were compared between the patients with complications and those without complications.Results Of the 101 patients, 35 (34.7%) had grade 2 or higher complications. Among those with complications, the 3- and 5-year OS rates were 63.5 and 58.2% and the 3- and 5-year RFS rates 41.7 and 41.7%, respectively. Among those without complications, the 3- and 5-year OS rates were 65.9 and 56.3% and the 3- and 5-year RFS rates 51.1 and 43.9%, respectively. There was no significant difference in prognosis between the patients with complications and those without complications.Conclusion Our study is the first to demonstrate the potential of NAC to abolish the poor prognosis induced by postoperative complications after curative resection for GC.