scholarly journals Adjuvant oxaliplatin plus S-1 (SOX) with concurrent radiotherapy versus SOX alone for gastric cancer with D2 lymph node dissection and high risk factors: a randomized phase III trial

2017 ◽  
Vol 28 ◽  
pp. v267
Author(s):  
X. Wang ◽  
Y. Shen ◽  
Q. Li ◽  
M. Qiu ◽  
Z. Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Phase Iii ◽  
Node Dissection ◽  
Phase Iii Trial ◽  
D2 Lymph Node Dissection ◽  
Concurrent Radiotherapy ◽  
High Risk Factors

Phase III Trial Comparing Capecitabine Plus Cisplatin Versus Capecitabine Plus Cisplatin With Concurrent Capecitabine Radiotherapy in Completely Resected Gastric Cancer With D2 Lymph Node Dissection: The ARTIST Trial

2012 ◽  
Vol 30 (3) ◽  
pp. 268-273 ◽  
Author(s):  
Jeeyun Lee ◽  
Do Hoon Lim ◽  
Sung Kim ◽  
Se Hoon Park ◽  
Joon Oh Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Postoperative Treatment ◽  
Node Dissection ◽  
Cancer Trial ◽  
D2 Lymph Node Dissection ◽  
Resected Gastric Cancer

Purpose The ARTIST (Adjuvant Chemoradiation Therapy in Stomach Cancer) trial was the first study to our knowledge to investigate the role of postoperative chemoradiotherapy therapy in patients with curatively resected gastric cancer with D2 lymph node dissection. This trial was designed to compare postoperative treatment with capecitabine plus cisplatin (XP) versus XP plus radiotherapy with capecitabine (XP/XRT/XP). Patients and Methods The XP arm received six cycles of XP (capecitabine 2,000 mg/m2 per day on days 1 to 14 and cisplatin 60 mg/m2 on day 1, repeated every 3 weeks) chemotherapy. The XP/XRT/XP arm received two cycles of XP followed by 45-Gy XRT (capecitabine 1,650 mg/m2 per day for 5 weeks) and two cycles of XP. Results Of 458 patients, 228 were randomly assigned to the XP arm and 230 to the XP/XRT/XP arm. Treatment was completed as planned by 75.4% of patients (172 of 228) in the XP arm and 81.7% (188 of 230) in the XP/XRT/XP arm. Overall, the addition of XRT to XP chemotherapy did not significantly prolong disease-free survival (DFS; P = .0862). However, in the subgroup of patients with pathologic lymph node metastasis at the time of surgery (n = 396), patients randomly assigned to the XP/XRT/XP arm experienced superior DFS when compared with those who received XP alone (P = .0365), and the statistical significance was retained at multivariate analysis (estimated hazard ratio, 0.6865; 95% CI, 0.4735 to 0.9952; P = .0471). Conclusion The addition of XRT to XP chemotherapy did not significantly reduce recurrence after curative resection and D2 lymph node dissection in gastric cancer. A subsequent trial (ARTIST-II) in patients with lymph node–positive gastric cancer is planned.

Safety and feasibility of adjuvant chemotherapy with S-1 in Korean patients with curatively resected advanced gastric cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 121-121
Author(s):  
Jae Ho Jeong ◽  
Min-Hee Ryu ◽  
Sung Sook Lee ◽  
Baek-Yeol Ryoo ◽  
Sang Hong Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Female Gender ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Korean Patients ◽  
Independent Risk Factors ◽  
Grade 3

121 Background: Adjuvant chemotherapy with S-1 has been proven effective for patients with curatively resected advanced gastric cancer with D2 lymph node dissection in Japan. We assessed the safety and feasibility of adjuvant S-1 chemotherapy in Korean patients with stage II, III or IV(M0) gastric cancer. Methods: A total of 305 patients with stage II, III or IV(M0) gastric cancer received adjuvant S-1 chemotherapy following curative gastrectomy with D2 lymph node dissection in Asan Medical Center between October 2007 and December 2009. Adjuvant chemotherapy with S-1 was started 3-6 weeks after surgery and it was administered orally twice daily at the dose of 40 mg/m2 for 4 weeks followed by 2 weeks of rest, every 6 weeks 8 times for 1 year. We retrospectively reviewed the medical records of the patients and evaluated the safety and feasibility of adjuvant S-1 chemotherapy in Korean patients. Results: Among the 305 patients, 248 (81.3%) and 198 (64.9%) patients completed 4 and 8 cycles of adjuvant chemotherapy, respectively. The most common reasons for discontinuation of treatment were adverse event (43.9%) and recurrence (26.2%). Among the 305 patients, 75 (24.6%) patients required dose reduction because of toxicities. The most common grade 3/4 toxicities were neutropenia (12.8%), diarrhea (5.3%), abdominal pain (3.8%), and anemia (3.3%). Multivariate analysis showed that total gastrectomy (H.R. 2.50; 95% C.I. 1.32-4.72, p=0.005) and female gender (H.R. 1.95; 95% C.I. 1.03-3.66, p=0.039) were independent risk factors for grade 3/4 hematologic toxicities, and old age (>65 years) (H.R. 2.92; 95% C.I. 1.50-5.69, p=0.002) was an independent risk factor for grade 3 non-hematologic toxicities. Conclusions: Adjuvant chemotherapy with S-1 for 1 year was safe and feasible in Korean patients. Old age, female gender, and total gastrectomy were independent risk factors for severe toxicities of adjuvant S-1 chemotherapy.

Đánh giá kết quả phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư

2021 ◽  
Author(s):  
Van Huong Nguyen
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Total Gastrectomy ◽  
Lymph Node Dissection ◽  
Laparoscopic Total Gastrectomy ◽  
Node Dissection ◽  
Female Ratio ◽  
D2 Lymph Node Dissection ◽  
Totally Laparoscopic Total Gastrectomy ◽  
Totally Laparoscopic

TÓM TẮT Đặt vấn đề: Nghiên cứu nhằm đánh giá kết quả phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư tại Bệnh viện Hữu nghị Đa khoa Nghệ An. Phương pháp: Nghiên cứu mô tả hồi cứu, gồm 126 bệnh nhân ung thư dạ dày được phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày vét hạch D2, từ 2013 đến 2020 Kết quả: Tuổi trung bình 60,6 ± 11,1 tuổi. Tỷ lệ nam/nữ 2.8/1. Ung thư ở giai đoạn I, II, III là 19,0%, 49,2%, 31,7%. Ung thư biểu mô tuyến nhú và ống là 70,6% và tế bào nhẫn là 24,6%. Tỷ lệ tai biến trong mổ của nhóm PTNS hoàn toàn là 4,4% và PTNS hỗ trợ 20,6%. Số hạch nạo vét được trung bình của 2 nhóm PTNS hoàn toàn là 23,7 ± 7,1 hạch và PTNS hỗ trợ là 18,0 ± 7,2 hạch. Lượng máu mất trung bình của PTNS hoàn toàn 30,56 ± 10,2 ml và PTNS hỗ trợ 36,11 ± 9,9 ml. Thời gian phẫu thuật trung bình của nhóm PTNS hoàn toàn là 206,4 ± 30,6 phút và PTNS hỗ trợ 220 ± 40,9 phút. Tỷ lệ biến chứng sau mổ của nhóm PTNS hoàn toàn là 4,4% và PTNS hỗ trợ là 22,3%. Thời gian nằm viện trung bình của nhóm PTNS hoàn toàn là 7,5 ± 2,1 ngày và PTNS hỗ trợ là 10,2 ± 2,4 ngày. Kết luận: Phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư là kỹ thuật an toàn và hiệu quả trong điều trị ung thư dạ dày. ABSTRACT EVALUATION OF OUTCOMES TOTALLY LAPAROSCOPIC TOTAL GASTRECTOMY AND LAPAROSCOPIC - ASSISTED TOTAL GASTRECTOMY WITH D2 LYMPH NODE DISSECTION DUE TO CANCER Introduction: To evaluate the results of totally laparoscopic total gastrectomy (TLTG) and laparoscopicassisted total gastrectomy (LATG) with D2 lymph node dissection to treat gastric cancer in the Nghean General Friendship Hospital. Materials and Methods: In a retrospective cohort study, 126 patients with gastric cancer underwent TLTG and LATG with D2 lymph node dissection between 2013 and 2020. Results: There were 126 patients with an average age of 60.6 ± 11.1 years. The male/female ratio was 2.8/1. The percent of patients with tumors at stages I, II, III were 19.0%, 49.2%, 31.7%, 70.6% of patients had papillary adenocarcinoma and tubular adenocarcinoma. Patients with ring cell carcinoma wereaccounted for 24.6%. The total percent of incidents during the surgery of the group of TLTG was 4.4%, and the group of LATG was 20.6%. The average number of harvested lymph nodes in the group of TLTG was 23.7 ± 7.1, and the group of LATG was 18.0 ± 7.2. The average blood loss in the group of TLTG was 30.56 ± 10.2 ml, and the group of LATG was 36.11 ± 9.9 ml, and the average operation time in the group of TLTG was 206.4 ± 30.6 minutes, and the group of LATG was 220 ± 40.9 minutes. The total percent of postoperative complications in the group of TLTG was 4.4%, and the group of LATG was 22.3%. The hospital stays in the group of TLTG was 7.5 ± 2.1 days, and the group of LATG was 10.2 ± 2.4 days. Conclusions: TLTG and LATGwith D2 lymph node dissectionwere safe and effective in treating gastric cancer. Keywords: Laparoscopic gastrectomy, gastric cancer, total gastrectomy

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