| Objective: To explore the safety of neoadjuvant chemotherapy for advanced stage(stage Ⅲ)gastric cancer and its recent efficacy.Methods: A total of 138 patients with locally advanced gastric cancer(stage Ⅲ)admitted to the Affiliated Tumor Hospital of Guangxi Medical University from March 2012 to March 2016 were enrolled in this study.50 patients underwent neoadjuvant chemotherapy,88 patients underwent direct surgical treatment,compare the occurrence of two groups of surgical complications and the recent level of efficacy.Results: The mean survival time was 36.9 months in the neoadjuvant chemotherapy group and 30.9 months(P=0.317)in the neoadjuvant chemotherapy group.The recurrence rates were 10.0%vs6.8%(P=0.737),16.0% vs 17.0%(P=0.874),and 34.0%vs52.3%(P=0.038)at 3 months,6 months,and 12 months respectively.After neoadjuvant chemotherapy 4 cases received complete remission(CR),18 cases received partial remission(PR),25 cases with the stable disease(SD),the radical resection rate of the neoadjuvant chemotherapy group was 84%,no neoadjuvant chemotherapy group was 68.2%(P=0.042).The incidence of major complications was not statistically significant(P>0.05),with duodenal stump fistula 2.0% vs0%(P=0.362),intraperitoneal hemorrhage 2.0% vs1.1%(P=1.0),anastomotic fistula 4.0% vs 2.3%(P= 0.957),intestinal obstruction 2.0% vs 3.4%(P=1.0),poor healing of incision 4.0% vs 2.3%(P=0.957).The difference of two groups of intraoperative blood transfusion,laparotomy,intraoperative blood loss,operation time and lymph node metastasis was statistically significant(P<0.05),there was no significant difference in the resection,hospitalization time and cost of other organs(P> 0.05).Lymph node metastasis,postoperative complications,age were poor prognostic factor(P> 0.05).Conclusion:Neoadjuvant chemotherapy can improve radical resection rate,reduce postoperative recurrence rate,it is a safe and effective treatment for advanced gastric cancer,but long-term efficacy still need further study. |
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