Surgical outcome after docetaxel-based neoadjuvant chemotherapy in locally-advanced gastric cancer

Roberto Biffi, Nicola Fazio, Fabrizio Luca, Antonio Chiappa, Bruno Andreoni, Maria Giulia Zampino, Arnaud Roth, Jan Christian Schuller, Giancarla Fiori, Franco Orsi, Guido Bonomo, Cristiano Crosta, Olivier Huber

Research output: Contribution to journalArticle

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Abstract

AIM: To investigate feasibility, morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastric cancer. METHODS: Patients suffering from locally-advanced (T3-4 any N M0 or any T N1-3 M0) gastric carcinoma, staged with endoscopic ultrasound, bone scan, computed tomography, and laparoscopy, were assigned to receive four 21 d/cycles of TCF (docetaxel 75 mg/m2 day 1, cisplatin 75 mg/m2 day 1, and fluorouracil 300 mg/m2 per day for days 1-14), either before (Arm A) or after (Arm B) gastrectomy. Operative morbidity, overall mortality, and severe adverse events were compared by intention-to-treat analysis. RESULTS: From November 1999 to November 2005, 70 patients were treated. After preoperative TCF (Arm A), thirty-two (94%) resections were performed, 85% of which were R0. Pathological response was complete in 4 patients (11.7%), and partial in 18 (55%). No surgical mortality and 28.5% morbidity rate were observed, similar to those of immediate surgery arm (P = 0.86). Serious chemotherapy adverse events tended to be more frequent in arm B (23% vs 11%, P = 0.07), with a single death per arm. CONCLUSION: Surgery following docetaxel-based chemotherapy was safe and with similar morbidity to immediate surgery in patients with locally-advanced resectable gastric carcinoma.

Original languageEnglish
Pages (from-to)868-874
Number of pages7
JournalWorld Journal of Gastroenterology
Volume16
Issue number7
DOIs
Publication statusPublished - Feb 21 2010

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docetaxel
Stomach Neoplasms
Drug Therapy
Morbidity
Gastrectomy
Mortality
Stomach
Carcinoma
Intention to Treat Analysis
Fluorouracil
Laparoscopy
Cisplatin
Tomography
Bone and Bones

Keywords

  • Docetaxel
  • Endoscopic ultrasonography
  • Gastric cancer
  • Laparoscopy
  • Morbidity
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Surgical outcome after docetaxel-based neoadjuvant chemotherapy in locally-advanced gastric cancer. / Biffi, Roberto; Fazio, Nicola; Luca, Fabrizio; Chiappa, Antonio; Andreoni, Bruno; Zampino, Maria Giulia; Roth, Arnaud; Schuller, Jan Christian; Fiori, Giancarla; Orsi, Franco; Bonomo, Guido; Crosta, Cristiano; Huber, Olivier.

In: World Journal of Gastroenterology, Vol. 16, No. 7, 21.02.2010, p. 868-874.

Research output: Contribution to journalArticle

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abstract = "AIM: To investigate feasibility, morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastric cancer. METHODS: Patients suffering from locally-advanced (T3-4 any N M0 or any T N1-3 M0) gastric carcinoma, staged with endoscopic ultrasound, bone scan, computed tomography, and laparoscopy, were assigned to receive four 21 d/cycles of TCF (docetaxel 75 mg/m2 day 1, cisplatin 75 mg/m2 day 1, and fluorouracil 300 mg/m2 per day for days 1-14), either before (Arm A) or after (Arm B) gastrectomy. Operative morbidity, overall mortality, and severe adverse events were compared by intention-to-treat analysis. RESULTS: From November 1999 to November 2005, 70 patients were treated. After preoperative TCF (Arm A), thirty-two (94{\%}) resections were performed, 85{\%} of which were R0. Pathological response was complete in 4 patients (11.7{\%}), and partial in 18 (55{\%}). No surgical mortality and 28.5{\%} morbidity rate were observed, similar to those of immediate surgery arm (P = 0.86). Serious chemotherapy adverse events tended to be more frequent in arm B (23{\%} vs 11{\%}, P = 0.07), with a single death per arm. CONCLUSION: Surgery following docetaxel-based chemotherapy was safe and with similar morbidity to immediate surgery in patients with locally-advanced resectable gastric carcinoma.",
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AU - Andreoni, Bruno

AU - Zampino, Maria Giulia

AU - Roth, Arnaud

AU - Schuller, Jan Christian

AU - Fiori, Giancarla

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AU - Crosta, Cristiano

AU - Huber, Olivier

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N2 - AIM: To investigate feasibility, morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastric cancer. METHODS: Patients suffering from locally-advanced (T3-4 any N M0 or any T N1-3 M0) gastric carcinoma, staged with endoscopic ultrasound, bone scan, computed tomography, and laparoscopy, were assigned to receive four 21 d/cycles of TCF (docetaxel 75 mg/m2 day 1, cisplatin 75 mg/m2 day 1, and fluorouracil 300 mg/m2 per day for days 1-14), either before (Arm A) or after (Arm B) gastrectomy. Operative morbidity, overall mortality, and severe adverse events were compared by intention-to-treat analysis. RESULTS: From November 1999 to November 2005, 70 patients were treated. After preoperative TCF (Arm A), thirty-two (94%) resections were performed, 85% of which were R0. Pathological response was complete in 4 patients (11.7%), and partial in 18 (55%). No surgical mortality and 28.5% morbidity rate were observed, similar to those of immediate surgery arm (P = 0.86). Serious chemotherapy adverse events tended to be more frequent in arm B (23% vs 11%, P = 0.07), with a single death per arm. CONCLUSION: Surgery following docetaxel-based chemotherapy was safe and with similar morbidity to immediate surgery in patients with locally-advanced resectable gastric carcinoma.

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