Efficacy of Neoadjuvant Chemotherapy on Locally Advanced Gastric Adenocarcinoma in Terms of Downstaging and Resectability in a Tertiary Cancer Hospital

Simple item page
dc.contributor.authorMazumder, Suzon Kumaren_US
dc.contributor.authorShirin, Lailaen_US
dc.contributor.authorDas, Chittaranjanen_US
dc.contributor.authorBardhan, Sushmitaen_US
dc.contributor.authorRoy, Ranada Prasaden_US
dc.contributor.authorKabir, SM Sakiben_US
dc.contributor.authorDey, Kallolen_US
dc.date.accessioned2023-07-21T11:26:29Z
dc.date.available2023-07-21T11:26:29Z
dc.date.issued2023-06
dc.description.abstractBackground: Neoadjuvant chemotherapy (NACT) in carcinoma stomach was introduced in an effort to eliminate micro-metastasis and to improve resectablity before surgery which improves R0 resection rates. The aim of the current study was to evaluate the effect of neoadjuvant chemotherapy on downstaging and resectability rate in locally advanced gastric cancer. Material & Methods: This was a single-center quasi-experimental study conducted in the Department of Surgical Oncology in collaboration with the Departments of Medical Oncology, Radiation oncology, and Pathology at the National Institute of Cancer Research and hospital, Dhaka, which is a tertiary care cancer hospital in Bangladesh, between January 2021 and June 2022.Patients with locally advanced adenocarcinoma stomach staged by contrast-enhanced computed tomography (CECT) were randomly included in this study by purposive sampling. Patients in Group I underwent upfront surgery Patients in Group II were started on neoadjuvant chemotherapy, either XELOX or FLOT regimen. Surgery was done following the response assessment CECT. We assessed R0 resection rate, age, sex, comorbidities, tumour size, TNM stage and complications were compared between the two groups. Response to NACT was assessed in Group II. Results: The mean age of patients in groups 1 & 2 was 56 ± 11.06 and 55.70 ± 10.46 years of age respectively (p > 0.05). Majority of the respondents (55/74) were male and 19 patients (26%) were female. Male to female ratio was (24/37 &31/37) in group 1 and (31/37 & 6/37) groups respectively (p > 0.05). Out of 37 patients who received NACT, in 9 patients (24.32%) complete response was noted. Partial response was found in 20 cases (54.05%), p-value (<.0001) while a stable disease was reported in three (8.1%) cases. 5 patients (13.51%) had progressive disease. In the upfront surgery group, R0 resection was feasible in 16 (43.2%) cases, and in the NACT plus surgery group, R0 resection was done in 29 (78.4%) cases. In group 1, R1 resection was done in considerable numbers (19/37) compared to group 2 (5/37), P=0.001. Three patients (8.1%) in group 2 and one (2.7) in group 1 had irresectable lesions. Conclusion: In this study it can be concluded that neoadjuvant chemotherapy could downstage tumour and increase tumor resectability rate in patients with locally-advanced gastric adenocarcinoma. However, further studies are necessary to confirm the effect of this modality on patients’ overall survival. We await survival analysis to further validate the role of NACT.en_US
dc.identifier.affiliationsConsultant, OSD, Department of Surgical Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh. Email: smazumder1205@gmail.com Orcid ID: 0009-0000-7936-359X.en_US
dc.identifier.affiliationsProfessor & Head, Department of Surgical Oncology, National Institute of Cancer Research & Hospital (NICRH), Email: drlshirin@gmail.com, Orcid ID: 0009-0002-4206-411X.en_US
dc.identifier.affiliationsAssociate Professor, Department of General Surgery, Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka, Bangladesh. Email: drchittabsmmu@gmail.com Orcid ID: 0009-0009-6509-3416en_US
dc.identifier.affiliationsIndoor Medical Officer, Department Of Gynaecological Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh. Email: drsushmi1184@gmail.com Orcid ID: 0009-0007-7963-1866.en_US
dc.identifier.affiliationsAssistant Professor, Department of Radiation Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh. Email: rproy11@gmail.com Orcid ID: 0009-0000-2692-5368.en_US
dc.identifier.affiliationsResident Surgical Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh. Email: sakib.kabir@gmail.com Orcid ID: 0009-0001-5784-7080.en_US
dc.identifier.affiliationsResident, Deparment of Surgical Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh. Email: drkalloldey85@gmail.com Orcid ID: 0009-0005-5550-9079.en_US
dc.identifier.citationMazumder Suzon Kumar, Shirin Laila, Das Chittaranjan, Bardhan Sushmita, Roy Ranada Prasad, Kabir SM Sakib, Dey Kallol. Efficacy of Neoadjuvant Chemotherapy on Locally Advanced Gastric Adenocarcinoma in Terms of Downstaging and Resectability in a Tertiary Cancer Hospital. Annals of International Medical and Dental Research. 2023 Jun; 9(3): 141-150en_US
dc.identifier.issn2395-2822
dc.identifier.issn2395-2814
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/220159
dc.languageenen_US
dc.publisherScholars Publisheren_US
dc.relation.issuenumber3en_US
dc.relation.volume9en_US
dc.source.urihttps://doi.org/10.53339/aimdr.2023.9.3.18en_US
dc.subjectLocally advanced gastric canceren_US
dc.subjectGastrectomyen_US
dc.subjectNeoadjuvant chemotherapyen_US
dc.subjectCarcinoma stomachen_US
dc.subjectSurgical outcomeen_US
dc.titleEfficacy of Neoadjuvant Chemotherapy on Locally Advanced Gastric Adenocarcinoma in Terms of Downstaging and Resectability in a Tertiary Cancer Hospitalen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
AIMDR2023v9n3p141.pdf
Size:
305.7 KB
Format:
Adobe Portable Document Format
Download
Collections
Annals of International Medical and Dental Research