| Objective To Analysis the prognosis and correlated risk factors of patients with stage III gastric cancer after Conversion therapy.Methods the clinical data of 40 patients with stage III gastric cancer were retrospectively evaluated.The patients were admitted in the department of Oncological Surgery in Fujian Provincial Hospital from June 2012 to March 2016.The patients received EOX chemotherapy during perioperative period.The curative effect and safety of EOX chemotherapy were assessed by every 2-3 cycles.The overall response rate(ORR)and disease control rate(DCR)of chemotherapy were assessed by image.The operation would be performed if the patients' tumors were resectable after chemotherapy.Median overall survival(OS),progression-free survival(PFS),one-year survival rate,two-year survival rate and three-year survival rate were observed.The prognosis was analyzed by multivariate prognostic analysis.Results 37 patients were followed up and the mean period of follow-up was 24.2months(5.5 to 53).The overall response rate(ORR)was 45.9%(17/37),and the disease control rate(DCR)was 83.8%(31/37).16 patients underwent radical surgery,and palliative surgery was performed in 5 patients,while 19 patients failed the indication for surgery.The median OS of those with radical operation has not arrived,and median OS of those with palliative surgery was 11m(95%CI 0.0-0.9)The median OS of those without operation was 18m(95%CI 0.0-37.8).Patients undergoing radical surgery had substantially better survival,compared with other two groups,with statistically significant difference(P < 0.05).No statistically difference was found between patients with palliative surgery and patients without surgery in terms of OS(P>0.05).Median PFS of patients with radical surgery, with palliative surgery,and without surgery was 27m(95%CI 0.236-0.745),4.5m(95%CI 3.426-5.574),6m(95%CI 0.000-12.237)respectively;PFS of patients with radical surgery was better than those with palliative surgery(P <0.05),and No statistically difference was found between patients with palliative surgery and patients without surgery in terms of PFS(P>0.05).A single factor analysis showed pathological types,preoperative staging and evaluation of chemotherapy efficacy were related to the prognosis.Multivariate prognostic analysis showed the efficacy of chemotherapy as an independent factor of prognosis(P=0.024,RR=2.916,95 % CI : 1.154-7.370).No Chemotherapyrelated or surgery-related deaths were observed.Conclusion Perioperative chemotherapy could prolong the survival of patients with stage III gastric cancer,and with radical surgery,the efficacy could be further enhanced.The efficacy of chemotherapy as an independent factor for the prognosis of patients. |
PDF Full Text Request