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

IF 0.5 Q4 ONCOLOGY

International Cancer Conference Journal Pub Date : 2025-02-03 eCollection Date: 2025-04-01 DOI:10.1007/s13691-025-00750-5

Mikihiro Kano, Noriaki Tokumoto, Kazuaki Tanabe, Jun Hihara, Kazuhiro Toyota, Ryuichi Hotta, Yoshihiro Saeki, Hirofumi Tazawa, Nobuaki Fujikuni

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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.

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局部进展期胃癌伴胰头浸润的新辅助化疗后胃切除术5例。

局部晚期胃癌（LAGC）伴胰头侵犯（T4b），尽管行根治性手术，但预后较差。在此，我们报告了新辅助化疗（NAC）在提高晚期胃癌胰腺浸润的可切除性方面的有效性。回顾性分析来自广岛临床肿瘤外科研究组（Hisco）数据库13家机构2018 - 2020年的2191例胃癌病例。其中，24例cT4b期胃癌患者中有5例接受了3 - 8个周期的NAC治疗。化疗后，3例患者行全胃切除术，2例患者行远端胃切除术，无患者行胰十二指肠切除术（PD）。所有5例患者均达到1b级或更高的化疗反应，只有1例病理显示胰腺残留浸润。本研究提示，对于伴有胰头侵犯的T4b期LAGC， NAC可能有可能避免PD的需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Cancer Conference Journal ONCOLOGY-

自引率

14.30%

发文量

期刊介绍： This online-only journal publishes original case reports on all types of cancer. In particular, we welcome not only case reports of educational value in the diagnosis and treatment of cancers, but also reports on molecularly analyzed cancer cases, including gene mutations, gene fusions, gene expression, and changes in copy number, regardless of their known clinical significance. Assessing the molecular analysis of a tumor usually requires a “cancer conference” in which experts from various fields discuss it. Even if the authors and their respective “cancer conference” were unable to determine the clinical significance of molecular changes at the time of submission and publication, their data may provide evidence that will help the scientific community develop precision medicine solutions in the future. We welcome case reports with reviews of the literature on similar cases, as they are more useful and valuable to readers than are reports of rare cases. International Cancer Conference Journal is the official publication of the Japan Society of Clinical Oncology (JSCO). - Presents an online-only collection of original case reports on all types of cancer - In particular, welcomes molecularly analyzed cancer cases - The Official Publication of the Japan Society of Clinical Oncology (JSCO)