Prognostic factors in patients who received paraaortic lymph node dissection for locally advanced gastric cancer with extensive lymph node metastasis

Author(s):  
Makoto Hikage ◽  
Keiichi Fujiya ◽  
Satoshi Kamiya ◽  
Yutaka Tanizawa ◽  
Etsuro Bando ◽  
...  
2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18263-e18263
Author(s):  
Hironaga Satake ◽  
Akira Miki ◽  
Hisateru Yasui ◽  
Akihito Tsuji

e18263 Background: Surgery with lymph node dissection is the primary treatment for patients with localized resectable gastric cancer. However, the prognosis of locally advanced gastric cancer is poor. One promising approach is neoadjuvant chemotherapy, however, the use of neoadjuvant chemotherapy consisting of oxaliplatin-based regimen for locally advanced gastric cancer has not been reported. Oxaliplatin-induced neurotoxicity may continue after the chemotherapy and interfere with patients’ daily activities. We conducted two prospective phase I study of oxaliplatin-based neoadjuvant chemotherapy for locally advanced gastric cancer and assessed the oxaliplatin-induced neuropathy using the FACT-Ga and FACT-GOG-Ntx assessments. Methods: We planned two cycles of oxaliplatin administration and evaluated oxaliplatin-induced neuropathy using the FACT-Ga and FACT-GOG-Ntx assessments. Patients with locally advanced gastric cancer received two cycles of neoadjuvant chemotherapy with oxaliplatin (100 or 130 mg/m2) on day 1, as well as S-1 (80 mg/m2/day, b.i.d.) or capecitabine (2000 mg/m2/day, b.i.d.) for 14 days, repeated every 3 weeks. They then underwent gastrectomy with curative D2/3 lymph-node dissection followed by adjuvant S-1 (80 mg/m2/day, b.i.d.) for one year. QoL was assessed at baseline and during treatment. Results: Twelve patients were enrolled and fully assessed the QoL. All patients were chmo-naïve and had a good performance status: median age 70y, 67% male. The mean dose intensity of delivered during the neoadjuvant chemotherapy was 96.0% for oxaliplatin. Peripheral neuropathy was observed in all patients but with no functional disorders. Median time to QoL deterioration in FACT-G and FACT-GOG-NTx was 3 weeks. There were correlation between oxaliplatin administration and QoL deterioration by the repeated-measures ANOVA. Conclusions: FACT-GOG-Ntx showed that sensory neuropathy caused a deterioration in QoL immediately after the initiation of preoperative oxaliplatin-based chemotherapy, but that QoL recovered after the neo-adjuvant chemotherapy. Clinical trial information: UMIN000015950,UMIN000015181.


2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 56-56
Author(s):  
Takashi Oshima ◽  
Yohei Miyagi ◽  
Naohide Oue ◽  
Munetaka Masuda ◽  
Yayoi Kimura

56 Background: The outcomes of patients with locally advanced gastric cancer who have highly advanced lymph node metastasis such as N3 remain poor despite radical resection. If the preoperative diagnoses of such patients improve, further improvement in treatment outcomes is expected to be obtained by means of personalized therapies such as preoperative chemotherapy; however, the accuracy of diagnosis remains unsatisfactory. Therefore, exploratory proteome analysis using sera was performed with the aim of developing a supplementary liquid-biopsy-based technique to diagnose highly advanced lymph node metastasis in patients with locally advanced gastric cancer. We report the results obtained thus far. Methods: The subjects were 24 patients with pT4a gastric cancer (12 with pN0 disease and 12 with pN3 disease). Proteins that had significantly different (P<0.001) expression levels in the preoperative serum on exploratory proteome analysis by liquid chromatography and mass spectrometry were identified. These proteins were verified by Enzyme-Linked ImmunoSorbent Assay (ELISA) using a different cohort (20 patients with pN0 disease and 13 with pN3 disease) from that described above. Results: In the exploratory proteome analysis, 2,357 kinds of proteins were identified and examined. Six these proteins were identified as candidate predictive markers of highly advanced lymph node metastasis. These proteins were verified using existing and newly developed ELISA kits, and reproducibility was verified for one protein (Protein V) (P = 0.003). Conclusions: The possibility of the supplementary diagnosis of highly advanced lymph node metastasis by liquid biopsy was suggested in patients with locally advanced gastric cancer. Further evaluations by prospective studies are now in progress, with the ultimate goal of clinical application.


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