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D2 lymphadenectomy is not only safe but necessary in the era of neoadjuvant chemotherapy

In World Journal of Surgical Oncology
Contributor(s): Goel M | Mehta S | Annaiah S | Suradkar K | Vinchurkar K | Talole SD | Barreto SG | shailushrikhande@hotmail.com | Shrikhande SV.
Material type: materialTypeLabelArticleSeries: Vol 11 Issues.Publisher: 2013Description: 31.Subject(s): Neoadjuvant chemotherapy | Mortality | Morbidity | Gastric cancer | Gastrectomy | D2 lymphadenectomy | DDC classification: In: World Journal of Surgical OncologySummary: BACKGROUND: Patients with locally advanced resectable gastric cancers are increasingly offered neoadjuvant chemotherapy (NACT) following the MAGIC and REAL-2 trials. However, information on the toxicity of NACT, its effects on perioperative surgical outcomes and tumor response is not widely reported in literature. METHODS: Analysis of a prospective database of gastric cancer patients undergoing radical D2 gastrectomy over 2 years was performed. Chemotherapy-related toxicity, perioperative outcomes and histopathological responses to NACT were analyzed. The data is presented and compared to a cohort of patients undergoing upfront surgery in the same time period. RESULTS: In this study, 139 patients (42 female and 97 male patients, median age 53 years) with gastric adenocarcinoma received NACT. Chemotherapy-related toxicity was noted in 32% of patients. Of the 139 patients, 129 underwent gastrectomy with D2 lymphadenectomy, with 12% morbidity and no mortality. Major pathological response of primary tumor
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BACKGROUND: Patients with locally advanced resectable gastric cancers are increasingly offered neoadjuvant chemotherapy (NACT) following the MAGIC and REAL-2 trials. However, information on the toxicity of NACT, its effects on perioperative surgical outcomes and tumor response is not widely reported in literature.

METHODS: Analysis of a prospective database of gastric cancer patients undergoing radical D2 gastrectomy over 2 years was performed. Chemotherapy-related toxicity, perioperative outcomes and histopathological responses to NACT were analyzed. The data is presented and compared to a cohort of patients undergoing upfront surgery in the same time period.

RESULTS: In this study, 139 patients (42 female and 97 male patients, median age 53 years) with gastric adenocarcinoma received NACT. Chemotherapy-related toxicity was noted in 32% of patients. Of the 139 patients, 129 underwent gastrectomy with D2 lymphadenectomy, with 12% morbidity and no mortality. Major pathological response of primary tumor

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