Neoadjuvant chemotherapy plus surgery for high-risk advanced gastric cancer: long-term results of KDOG1001 trial
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ORIGINAL ARTICLE
Neoadjuvant chemotherapy plus surgery for high-risk advanced gastric cancer: long-term results of KDOG1001 trial Kei Hosoda 1 & Chikatoshi Katada 2 & Kenji Ishido 2 & Masahiro Niihara 1 & Hideki Ushiku 1 & Mikiko Sakuraya 1 & Marie Washio 1 & Takuya Wada 2 & Akinori Watanabe 2 & Hiroki Harada 1 & Takeo Sato 3 & Hiroshi Tajima 4 & Takashi Kaizu 4 & Yoshimasa Kosaka 5 & Hiroshi Kato 5 & Norihiko Sengoku 5 & Kiyoshi Tanaka 4,6 & Takeshi Naito 3 & Yusuke Kumamoto 4 & Takafumi Sangai 5 & Satoshi Tanabe 2 & Wasaburo Koizumi 2 & Keishi Yamashita 1,7 & Naoki Hiki 1 Received: 30 April 2020 / Accepted: 29 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The purpose of this study is to evaluate the long-term survival outcomes of KDOG1001 trial after a minimum follow-up of 3 years. Methods Patients with bulky N2 lymph nodes, linitis plastica (type 4), or large ulcero-invasive-type tumors (type 3) received up to four 28-day cycles of DCS neoadjuvant chemotherapy (docetaxel at 40 mg/m2, cisplatin at 60 mg/m2 on day 1, and S-1 at 40 mg/m2 twice daily for 2 weeks) followed by gastrectomy with D2 lymphadenectomy plus adjuvant S-1 therapy for 1 year. The final preplanned analysis of long-term outcomes including overall survival and relapse-free survival was conducted after minimum follow-up of 3 years. This trial is registered with the University Hospital Medical Information Network Clinical Trials Registry, number UMIN 000003642, and has been completed. Results From May 2010 through January 2017, 40 patients were enrolled. All included patients underwent neoadjuvant chemotherapy with DCS followed by gastrectomy with D2 lymphadenectomy, and 32 (80%) completed adjuvant S-1 therapy for 1 year. After a median follow-up for surviving patients of 68 months at the last follow-up in January 2020, 3-year overall survival rate was 77.5% (95% confidence interval 62.1–87.9%), while 3-year relapse-free survival rate was 62.5% (95% confidence interval 46.8–76.0%). Conclusion Neoadjuvant chemotherapy with 4 cycles of DCS followed by D2 gastrectomy plus adjuvant S-1 was associated with relatively good long-term oncologic outcomes for patients with the high-risk gastric cancer. Keywords Neoadjuvant chemotherapy . Gastrectomy . Stomach neoplasm . Lymphatic metastasis . Linitis plastica
Introduction Surgical resection remains mainstay of curative treatment for patients with gastric cancer. However, particularly in those with high risk of recurrence such as those with bulky lymph nodes along the celiac, splenic, common hepatic, or proper hepatic arteries (bulky N2 lymph nodes); linitis plastica (type 4); or large ulcero-invasive-type (type 3), the prognosis remains poor even when the tumor can be curatively resected [1–3]. Those with high risk of recurrence have been the target of clinical trials. The Japan Clinical Oncology Group (JCOG) has conducted a phase II trial (JCOG0405 [3]) to evaluate the
* Kei Hosoda [email protected] Extended author information available on the last page o
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