演題番号 : P9-6
In StageIV gastric cancer, chemotherapy is the first choice. But recently there are many reports that conversion therapy can prolong the survival. The purpose of this study is to investigate the usefulness of conversion surgery.
The subjects of this retrospective study were 35 patients with initially unresectable gastric cancer, who underwent surgical resection between 2007 and 2017, after down-staging or disease control was achieved by chemotherapy. We evaluated the clinicopathological factors and clinical outcomes.
The average of the age: 66, male/female 23/12. The factor of the unresectable: LN meta/peritoneal dissemination/liver meta/lung meta: 16/15/5/1. The Yoshida's criteria: Category1/2/3/4: 16/7/11/1. The regimen of the chemotherapy, ipPTX+S1/DCS/SP: 6/28/1. The duration of the preoperative chemotherapy is 144 days, and performed operation was TG/DG: 30/5. The extend of the LN dissection is D2/D2+:21/14. The operation of R0/R1/R2: 20/7/8. The histological evaluation is Grade0/1a/1b/2/3: 6/14/7/5/3. Overall survival in R0/R1/R2: 979/799/453 days. R2 is significantly worse compared with R0/R1. The survival rate in R0 patients is similar to the StageIII gastric cancer. Now we perform the preoperative staging laparoscopy for all patients with estimated R0 conversion surgery.
R0 surgical resection after chemotherapy for initially unresectable gastric cancer was useful. It is necessary to perform the staging laparoscopy before conversion surgery.