| Objective:The preoperative nutritional status,short-term clinical effect,safety,R0 removal rate,postoperative complications and near-term survival status of patients with locally advanced gastric cancer after preoperative neoadjuvant chemotherapy were analyzed,so as to further explore and learn the clinical application of neoadjuvant chemotherapy.Methods:Based on a retrospective analysis of the clinical data of 4 0 patients with advanced gastric cancer admitted to the gastrointestinal surgery Department of our hospital from September 2020 to September 2022,the patients were divided into two groups according to whether neoadjuvant chemotherapy or not: preoperative neoadjuvant chemotherapy combined with surgical resection as the experimental group,a total of 1 5 cases;There were 2 5 patients in the control group who received no neoadjuvant chemotherapy before surgery.Preoperative nutritional status,near-term clinical effect and safety of neoadjuvant chemotherapy were observed in the experimental group after neoadjuvant chemotherapy,and differences in R0 removal rate,postoperative complications and near-term survival were compared between the two groups.Results:Each of the 25 patients in the test group received an average of 3.7cycles of neoadjuvant chemotherapy before surgery;BMI,pre-serum albumin level,serum albumin level and serum total protein level were significantly improved,and preoperative nutritional status was greatly enhanced;BMI,pre-serum albumin level,serum albumin level and serum total protein level were not significantly improved after chemotherapy in the test group compared with the control group;after chemotherapy in phase III in the test group BMI,pre-serum albumin level,serum albumin level and serum total protein level were significantly improved in the test group after chemotherapy compared with the control group in stage III.The preoperative clinical outcomes were evaluated and the results were: partial remission(PR)in 7(28%)cases,stable disease in 16(64%)cases,and disease progression in 2(8%)cases.The efficiency of preoperative neoadjuvant chemotherapy(CR+PR)was 28%(7/25)and the disease control rate(CR+PR+SD)was 92%(23/25).However,there was no statistically significant difference in the study data regarding the R0 resection rate.As of the follow-up date,the survival rate was 76% in the trial group and 64% in the control group,and the survival rate was higher in the trial group than in the control group,with a statistically significant difference(log-rank test X2=10.463,p=0.001),and the mean survival days in the trial group was higher than the mean survival days in the control group(509.44±156.45 d vs.379.96± 134.89d)The predicted mean survival days were 717.45±51.19 days and the predicted median survival days were 751.27±13.55 days in the test group and 510.72±37.03 days and544.00±5.06 days in the control group.There was no significant difference in the incidence of postoperative complications between patients in the trial and control groups(P > 0.05),and the neoadjuvant chemotherapy drugs had a low incidence of adverse reactions and a high safety profile.Conclusions:1.Neoadjuvant chemotherapy can improve the nutritional status of patients before surgery,and the effect of phase III is remarkable.2.Neoadjuvant chemotherapy has a high safety level and can be tolerated by most patients.3.Neoadjuvant chemotherapy does not increase the incidence of postoperative complications in gastric cancer patients4.Neoadjuvant chemotherapy has obvious recent clinical effects and can improve patients’ recent survival time. |
PDF Full Text Request