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Neoadjuvant chemotherapy with FOLFOX4 regimen to treat advanced gastric cancer improves survival without increasing adverse events: a retrospective cohort study from a Chinese center.

Sun Z, Zhu RJ, Yang GF, Li Y - ScientificWorldJournal (2014)

Bottom Line: R0 resection, survival, and adverse events were compared.The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05).The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, No. 169 Donghu Road, Wuchang District, Wuhan 430071, China.

ABSTRACT

Background/aim: To evaluate the clinical efficacy of FOLFOX4 (5-fluomumcil/leucovorin combined and oxaliplatin) neoadjuvant chemotherapy for advanced gastric cancer (AGC).

Patients and methods: Fifty-eight AGC patients were enrolled in this retrospective cohort study, 23 in the neoadjuvant group and 35 in the adjuvant group. R0 resection, survival, and adverse events were compared.

Results: The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05). The number of lymph node metastases in the neoadjuvant group (3 (0-14)) was significantly fewer than that in the adjuvant group (6 (0-27)) (P = 0.04). The neoadjuvant group had significantly better median overall survival (29.0 versus 22.0 months) and 3-year survival rate (73.9% versus 40.0%) than the adjuvant group (P = 0.013). The positive expression rate of Ki-67 in the neoadjuvant group (40.0%, 8/20) was lower than that in the adjuvant group (74.2%, 23/31; P = 0.015).

Conclusion: The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

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Related in: MedlinePlus

Immunohistochemical staining of Ki-67 ((a) brown stain in nuclei), c-erbB-2 ((b) brown stain in membrane and cytoplasm), MMP-9 ((c) brown stain in membrane and cytoplasm) and microvessels. (d) Original magnification 100x; insets 400x. All tissues were adenocarcinoma of GC.
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fig2: Immunohistochemical staining of Ki-67 ((a) brown stain in nuclei), c-erbB-2 ((b) brown stain in membrane and cytoplasm), MMP-9 ((c) brown stain in membrane and cytoplasm) and microvessels. (d) Original magnification 100x; insets 400x. All tissues were adenocarcinoma of GC.

Mentions: Ki-67 positive rate in the neoadjuvant group (60.0%, 12/20) was slightly lower than that in the adjuvant group (74.2%, 23/31; P = 0.286) (Figure 2). Ki-67 positive tumors had a negative correlation with histopathological response to neoadjuvant chemotherapy as evidenced by a response rate of 2 or 3 (P = 0.007). There were no significant associations between Ki-67 expression and other variables such as invasion depth, nodal involvement, and TNM stage. The median OS in Ki-67 positive patients was 21.1 versus 45.9 months in Ki-67 negative patients (P = 0.010; Figure 1(e)). The median PFS in Ki-67 positive patients was 17.6 versus 45.3 months in Ki-67 negative patients (P = 0.061; Figure 1(f)).


Neoadjuvant chemotherapy with FOLFOX4 regimen to treat advanced gastric cancer improves survival without increasing adverse events: a retrospective cohort study from a Chinese center.

Sun Z, Zhu RJ, Yang GF, Li Y - ScientificWorldJournal (2014)

Immunohistochemical staining of Ki-67 ((a) brown stain in nuclei), c-erbB-2 ((b) brown stain in membrane and cytoplasm), MMP-9 ((c) brown stain in membrane and cytoplasm) and microvessels. (d) Original magnification 100x; insets 400x. All tissues were adenocarcinoma of GC.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4127276&req=5

fig2: Immunohistochemical staining of Ki-67 ((a) brown stain in nuclei), c-erbB-2 ((b) brown stain in membrane and cytoplasm), MMP-9 ((c) brown stain in membrane and cytoplasm) and microvessels. (d) Original magnification 100x; insets 400x. All tissues were adenocarcinoma of GC.
Mentions: Ki-67 positive rate in the neoadjuvant group (60.0%, 12/20) was slightly lower than that in the adjuvant group (74.2%, 23/31; P = 0.286) (Figure 2). Ki-67 positive tumors had a negative correlation with histopathological response to neoadjuvant chemotherapy as evidenced by a response rate of 2 or 3 (P = 0.007). There were no significant associations between Ki-67 expression and other variables such as invasion depth, nodal involvement, and TNM stage. The median OS in Ki-67 positive patients was 21.1 versus 45.9 months in Ki-67 negative patients (P = 0.010; Figure 1(e)). The median PFS in Ki-67 positive patients was 17.6 versus 45.3 months in Ki-67 negative patients (P = 0.061; Figure 1(f)).

Bottom Line: R0 resection, survival, and adverse events were compared.The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05).The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, No. 169 Donghu Road, Wuchang District, Wuhan 430071, China.

ABSTRACT

Background/aim: To evaluate the clinical efficacy of FOLFOX4 (5-fluomumcil/leucovorin combined and oxaliplatin) neoadjuvant chemotherapy for advanced gastric cancer (AGC).

Patients and methods: Fifty-eight AGC patients were enrolled in this retrospective cohort study, 23 in the neoadjuvant group and 35 in the adjuvant group. R0 resection, survival, and adverse events were compared.

Results: The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05). The number of lymph node metastases in the neoadjuvant group (3 (0-14)) was significantly fewer than that in the adjuvant group (6 (0-27)) (P = 0.04). The neoadjuvant group had significantly better median overall survival (29.0 versus 22.0 months) and 3-year survival rate (73.9% versus 40.0%) than the adjuvant group (P = 0.013). The positive expression rate of Ki-67 in the neoadjuvant group (40.0%, 8/20) was lower than that in the adjuvant group (74.2%, 23/31; P = 0.015).

Conclusion: The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

Show MeSH
Related in: MedlinePlus