Fonseca Telma, Coimbra Mariana, Barbosa Elisabete, Barbosa José
Department of General Surgery, Centro Hospitalar Universitário São João.
Faculty of Medicine of Porto University, Porto, Portugal.
Cir Cir. 2022;90(S2):36-41. doi: 10.24875/CIRU.21000657.
Gastric cancer is the fourth cancer most common in the world and the second cause of cancer-related deaths. Perioperative chemotherapy may reduce tumor burden and decrease lymph node invasion, improving R0 resections rates. On the other hand, administered before surgery, chemotherapy may cause fibrosis and tissue edema, with potential increase of surgical difficulty and in the number of post-operative complications. Therefore, we aim to investigate the effect of perioperative chemotherapy for tumor burden and metastatic lymph nodes of gastric cancer.
Retrospective analysis of all patients submitted to perioperative chemotherapy and surgery, between January 2010 and June 2020, which showed lymph node regression and tumor regression (Becker's classification).
A total of 112 patients with an average age of 61.9 years were analyzed. About 90.2% completed three cycles of perioperative chemotherapy. Good tumor response to chemotherapy (<10% residual tumor) was achieved in 21.3% of patients. Only three patients obtained a complete pathological response. A median lymph node response of 33.3% was achieved in our series.
Despite no evident outstanding regression rate was observed, perioperative chemotherapy seems to be useful in obtaining a R0 resection in gastric cancer, even in advanced gastric cancer.
胃癌是全球第四大常见癌症，也是癌症相关死亡的第二大原因。围手术期化疗可减轻肿瘤负荷并减少淋巴结侵犯，提高R0切除率。另一方面，在手术前进行化疗可能会导致纤维化和组织水肿，从而可能增加手术难度和术后并发症的数量。因此，我们旨在研究围手术期化疗对胃癌肿瘤负荷和转移性淋巴结的影响。
对2010年1月至2020年6月期间接受围手术期化疗和手术且显示淋巴结消退和肿瘤消退（贝克尔分类）的所有患者进行回顾性分析。
共分析了112例平均年龄为61.9岁的患者。约90.2%的患者完成了三个周期的围手术期化疗。21.3%的患者化疗后肿瘤反应良好（残留肿瘤<10%）。只有3例患者获得了完全病理缓解。我们的系列研究中淋巴结反应的中位数为33.3%。
尽管未观察到明显的显著消退率，但围手术期化疗似乎有助于胃癌的R0切除，即使是晚期胃癌。
