Neoadjuvant chemotherapy versus surgery alone for locally advanced gastric cancer: a retrospective comparative study.

BACKGROUND/AIMS: Preoperative chemotherapy is considered an effective treatment option for patients with gastric cancer. We retrospectively evaluated neoadjuvant chemotherapy with oxaliplatin, leucovorin and 5-flurouracil (OLF) in patients with locally advanced gastric cancer to determine its feasibility, as well as impact on the curative resection rate and patients' survival.

METHODOLOGY

A total of 87 patients with locally advanced gastric cancer that underwent preoperative chemotherapy combined with surgery or surgery alone were randomly matched according to the clinical TNM stage. The clinical responses to chemotherapy were assessed. The curative rate, postoperative complications and patients' survival between both groups were compared.

RESULTS

The two groups were well matched. Complete or partial response was observed in 51.7% (15/29) of patients in the OLF group, and three (10.3%) of them had complete pathologic response. The curative resection rates were 89.7% in the OLF group and 77.6% in the surgery alone group. The postoperative complications were equal for both groups. The mean survival is 20.6 months in the OLF group vs. 19.9 months in the surgery alone group (p=0.02).

CONCLUSIONS

Neoadjuvant chemotherapy using OLF combination is active in gastric cancer and the toxicity level is acceptable. This treatment improves the curative resection rate and patients' survival in locally advanced gastric cancer.