Impact of neoadjuvant chemotherapy in the treatment of patients with gastric cancer

Abstract

Introduction: Neoadjuvant chemotherapy (NeoCh) is the current standard of care for stage II/III gastric cancer tumours in Europe. However, when it concerns patients that endure complications during NeoCh, it's unclear if it increases the risk of postoperative complications and other poorer surgical outcomes. We aim to demonstrate if there's an association between complications during NeoCh and postoperative complications and the histopathological response to preoperatory treatment. Methods: We conducted a retrospective, transversal and observational study, including all patients with diagnosed gastric cancer that underwent NeoCh followed by surgical resection during the period of eight years. Results: We included 89 patients with a mean age of 61,5 years (SD 10,2). All completed a NeoCh regimen for a median of 72,3 days (range 438) and were also submitted to gastric resection: 58,4% total gastrectomy, 39,3% partial gastrectomy and 2,2% totalization of previous gastrectomy. Fourteen-point six percent of the patients had no complications during the NeoCh period and 14,6% had >2 complications. Twenty-one-point four percent of patients had a histological response for <10% of tumour burden, but in 46,1% only regression for <50% could be obtained. No significant association was found between complications during NeoCh and adverse surgical outcomes (p=0,751). Patients with complications during NeoCh had a greater survival and slightly higher median time difference from end of NeoCh until surgery, but with no statistical significance (p=0,336 and p=0,485, respectively). Conclusions: In our sample, it wasn't demonstrated the existence of an association between complications during NeoCh and postoperative complications. Nonetheless, these patients seem to benefit in histopathological regression and eventually have a better prognosis after surgery. Key words: gastric cancer, neoadjuvant chemotherapy, postoperative complications