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03-02-2025 | Gastric Cancer | Case report - Surgery

Gastrectomy after neoadjuvant chemotherapy in five cases of locally advanced gastric cancer with pancreatic head invasion

Authors: Mikihiro Kano, Noriaki Tokumoto, Kazuaki Tanabe, Jun Hihara, Kazuhiro Toyota, Ryuichi Hotta, Yoshihiro Saeki, Hirofumi Tazawa, Nobuaki Fujikuni, Hiroshima Surgical Study Group of Clinical Oncology (HiSCO)

Published in: International Cancer Conference Journal

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Abstract

Locally advanced gastric cancer (LAGC) with pancreatic head invasion (T4b) carries a poor prognosis despite radical surgery. Herein, we report the effectiveness of neoadjuvant chemotherapy (NAC) in improving the resectability of advanced gastric cancer with pancreatic invasion. A total of 2191 cases of gastric cancer were retrospectively analyzed from 13 institutions within the Hiroshima Surgical Study Group of Clinical Oncology (Hisco) database from 2018 to 2020. Among them, 5 of the 24 patients with Stage cT4b gastric cancer underwent NAC for three-to-eight cycles. Following chemotherapy, three patients underwent total gastrectomy, two patients underwent distal gastrectomy, and no patient underwent pancreaticoduodenectomy (PD). All five patients achieved a chemotherapeutic response of Grade 1b or higher, and only one case showed residual pancreatic invasion on pathology. This study suggests that NAC for Stage T4b LAGC with pancreatic head invasion may have the potential to obviate the need for PD.
Literature
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go back to reference Zhang X, Liang H, Li Z et al (2021) Perioperative or postoperative adjuvant oxaliplatin with S-1 versus adjuvant oxaliplatin with capecitabine in patients with locally advanced gastric or gastro-oesophageal junction adenocarcinoma undergoing D2 gastrectomy (RESOLVE): an open-label, superiority and non-inferiority, phase 3 randomised controlled trial. Lancet Oncol 22:1081–1092. https://doi.org/10.1016/S1470-2045(21)00297-7CrossRefPubMed Zhang X, Liang H, Li Z et al (2021) Perioperative or postoperative adjuvant oxaliplatin with S-1 versus adjuvant oxaliplatin with capecitabine in patients with locally advanced gastric or gastro-oesophageal junction adenocarcinoma undergoing D2 gastrectomy (RESOLVE): an open-label, superiority and non-inferiority, phase 3 randomised controlled trial. Lancet Oncol 22:1081–1092. https://​doi.​org/​10.​1016/​S1470-2045(21)00297-7CrossRefPubMed
Metadata
Title
Gastrectomy after neoadjuvant chemotherapy in five cases of locally advanced gastric cancer with pancreatic head invasion
Authors
Mikihiro Kano
Noriaki Tokumoto
Kazuaki Tanabe
Jun Hihara
Kazuhiro Toyota
Ryuichi Hotta
Yoshihiro Saeki
Hirofumi Tazawa
Nobuaki Fujikuni
Hiroshima Surgical Study Group of Clinical Oncology (HiSCO)
Publication date
03-02-2025
Publisher
Springer Nature Singapore
Published in
International Cancer Conference Journal
Electronic ISSN: 2192-3183
DOI
https://doi.org/10.1007/s13691-025-00750-5

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