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Keywords:

  • gastric cancer;
  • preoperative chemotherapy;
  • type 4 gastric cancer;
  • linitis plastica;
  • type 3 gastric cancer

Abstract

Background and Objectives

We conducted a phase II study to evaluate the safety and efficacy of preoperative chemotherapy with S-1 + cisplatin followed by gastrectomy in patients with linitis plastica (type 4) or large ulcero-invasive-type (type 3) gastric cancer.

Methods

Eligibility criteria included histologically proven adenocarcinoma of the stomach; clinically resectable gastric cancer of type 4 or type 3. Patients received two 28-day courses of preoperative chemotherapy of S-1 (80–120 mg/body, p.o., days 1–21) and cisplatin (CDDP; 60 mg/m2, i.v., day 8). Primary endpoints were completion of protocol treatment and incidence of treatment-related death (TRD).

Results

Among the 49 eligible patients with the median age of 61 years, 36 completed the protocol treatment comprising two courses of preoperative chemotherapy and R0/1 resection (73.5% completion, 80% CI, 63.7–81.7%). One TRD was observed during the first course of chemotherapy. Median survival and 3-year overall survival were 17.3 months and 24.5%, respectively.

Conclusions

Preoperative chemotherapy with S-1 + CDDP followed by gastrectomy is a safe and promising treatment for type 4 and large type 3 gastric cancers. Based on the results of this study, we are now conducting a phase III study (JCOG0501) to confirm the superiority of this treatment. J. Surg. Oncol. 2013;107:741–745. © 2013 Wiley Periodicals, Inc.