SOX Neoadjuvant Chemotherapy Followed by Surgery for Resectable Advanced Gastric Cancer with Multiple Lymph-node Metastasis

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  • SOX療法による術前補助化学療法を施行した高度リンパ節転移を伴う切除可能進行胃癌の検討

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<p>Neoadjuvant chemotherapy (NAC) is considered to be effective to improve the outcome of advanced gastric cancer patients with multiple lymph node metastases. We examined the data of 8 resectable advanced gastric cancer patients with multiple lymph node metastases who received preoperative NAC with the SOX regimen between 2015 and 2019 at our hospital. Clinical evaluation by RECIST version 1.1 revealed PR in 6 cases, SD in 2 cases, and PD in 0 case. The histopathological staging was as follows: stage ⅠB, 3 cases; stage ⅡA, 1 case; stage ⅡB, 2 cases; stage ⅢA, 2 cases. Downstaging was noted in 7 of the 8 patents (87.5%). The histopathological effects were as follows: Grade Ⅰa, 3 cases; Grade Ⅰb, 2 cases; Grade 2a, 2 cases; Grade 2b, 1 case. Adverse events during the NAC classified according to the CTCAE were as follows: anemia, 1 case (Grade 1); nausea, 1 case (Grade 1); peripheral neuropathy, 1 case (Grade 1); anemia, 2 cases (Grade 2). There were no adverse events that were more than Grade 3 in severity. Distal gastrectomies in 3 cases and total gastrectomies in 5 patients were performed, with D2 dissection. There were no postoperative complications and all the patients remain alive without recurrence.</p><p>We considered that NAC with SOX may be the treatment of choice for patients with resectable stage Ⅲ advanced gastric cancer with multiple lymph node metastases.</p>

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