Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer.

Abstract:

OBJECTIVE:In Western populations, long-term survival rates after curative resection of gastric cancer remain extremely poor. The lack of effective adjuvant therapy has prompted the evaluation of neoadjuvant approaches. Since 1988, we have conducted three separate phase II trials using neoadjuvant chemotherapy to treat patients with potentially resectable gastric cancer. The present study was conducted to evaluate whether response to neoadjuvant chemotherapy is predictive of survival in patients with resectable gastric cancer. METHODS:Eighty-three patients with pathologically confirmed gastric adenocarcinoma were treated with neoadjuvant chemotherapy before planned surgical resection. Response was assessed by upper gastrointestinal series, endoscopy, computed tomography scan, and pathologic examination. RESULTS:For the three phase II trials, clinical response rates ranged from 24% to 38%. Three patients (4%) had a complete pathologic response. Sixty-one patients (73%) underwent a curative resection. Median follow-up was 26 months. Univariate analysis revealed T stage, number of positive nodes, and response to chemotherapy to be significant predictors of overall survival. However, on multivariate analysis, response to chemotherapy was found to be the only independent prognostic factor. CONCLUSIONS:Response to neoadjuvant chemotherapy is the single most important predictor of overall survival after neoadjuvant chemotherapy for gastric cancer. These findings support further evaluation of neoadjuvant approaches in the treatment of this disease.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Lowy AM,Mansfield PF,Leach SD,Pazdur R,Dumas P,Ajani JA

doi

10.1097/00000658-199903000-00001

subject

Has Abstract

pub_date

1999-03-01 00:00:00

pages

303-8

issue

3

eissn

0003-4932

issn

1528-1140

journal_volume

229

pub_type

临床试验,杂志文章
  • Neurovascular compression in the thoracic outlet: changing management over 50 years.

    abstract:SUMMARY BACKGROUND DATA:During the past five decades, significant improvements have been made in the diagnosis and treatment of thoracic outlet syndrome (TOS) secondary to sports activities, breast implants, or median sternotomy. METHODS, RESULTS, AND CONCLUSIONS:Of more than 15,000 patients evaluated for TOS, 3914 un...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199810000-00017

    authors: Urschel HC Jr,Razzuk MA

    更新日期:1998-10-01 00:00:00

  • Management Considerations for the Surgical Treatment of Colorectal Cancer During the Global Covid-19 Pandemic.

    abstract:OBJECTIVE:The COVID-19 pandemic requires to conscientiously weigh "timely surgical intervention" for colorectal cancer against efforts to conserve hospital resources and protect patients and health care providers. SUMMARY BACKGROUND DATA:Professional societies provided ad-hoc guidance at the outset of the COVID-19 pan...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004029

    authors: O'Leary MP,Choong KC,Thornblade LW,Fakih MG,Fong Y,Kaiser AM

    更新日期:2020-08-01 00:00:00

  • Pregnancy As a Risk Factor for Small Bowel Obstruction After Laparoscopic Gastric Bypass Surgery.

    abstract:OBJECTIVE:To evaluate whether pregnancy is associated with increased risk for small bowel obstruction after laparoscopic gastric bypass surgery. BACKGROUND:Small bowel obstruction is a common and feared long-term complication to laparoscopic gastric bypass surgery that may be more common during pregnancy. It is unclea...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003163

    authors: Stenberg E,Chen R,Hildén K,Fall K

    更新日期:2020-07-01 00:00:00

  • Overestimation of hereditary breast cancer risk.

    abstract:OBJECTIVE:To find out how women with breast or ovarian cancer rate their chances of carrying hereditary factors for these cancers and to determine the extent to which they overestimate their risk. SUMMARY BACKGROUND DATA:BRCA1 and BRCA2 are genes that cause breast and ovarian cancer when they are inherited in families...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199809000-00010

    authors: Iglehart JD,Miron A,Rimer BK,Winer EP,Berry D,Shildkraut MJ

    更新日期:1998-09-01 00:00:00

  • Weekday of Esophageal Cancer Surgery and Its Relation to Prognosis.

    abstract:OBJECTIVE:To assess whether weekday of surgery influences long-term survival in esophageal cancer. BACKGROUND:Increased 30-day mortality rates have been reported in patients undergoing elective surgery later compared with earlier in the week. METHODS:This population-based cohort study included 98% of all esophageal c...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001324

    authors: Lagergren J,Mattsson F,Lagergren P

    更新日期:2016-06-01 00:00:00

  • Fibrin sealant versus mechanical stapling for mesh fixation during endoscopic extraperitoneal inguinal hernioplasty: a randomized prospective trial.

    abstract:OBJECTIVE:To compare the clinical outcome of simultaneous bilateral endoscopic totally extraperitoneal inguinal hernioplasty (TEP) using fibrin sealant (FS) and mechanical stapling for prosthetic mesh fixation. SUMMARY BACKGROUND DATA:Similar efficacy of FS and mechanical stapling for mesh fixation has been demonstrat...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/01.sla.0000186440.02977.de

    authors: Lau H

    更新日期:2005-11-01 00:00:00

  • A randomized clinical trial of moxalactam alone versus tobramycin plus clindamycin in abdominal sepsis.

    abstract::One hundred patients with intraabdominal infections were assigned randomly in double-blind fashion to receive either the combination of tobramycin plus clindamycin (TM/C) or moxalactam (MOX) alone. Fifty patients comprised each group, but one patient in each group died of infection before 48 hours treatment. In the re...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-198307000-00007

    authors: Schentag JJ,Wels PB,Reitberg DP,Walczak P,Van Tyle JH,Lascola RJ

    更新日期:1983-07-01 00:00:00

  • Resting energy expenditure in controls and cancer patients with localized and diffuse disease.

    abstract::Resting energy expenditure (REE), nutritional parameters, and substrate levels were measured using a technique to minimize artifacts in 11 control patients, nine patients with localized, and four patients with diffuse neoplastic disease. Patients with diffuse disease had significantly increased percentage preillness w...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198403000-00008

    authors: Arbeit JM,Lees DE,Corsey R,Brennan MF

    更新日期:1984-03-01 00:00:00

  • Nutritional consequences of total gastrectomy.

    abstract::Nutritional status was investigated in 10 patients who had previously undergone total gastrectomy without evidence of malignancy. The ability of these patients to ingest and absorb adequate amounts of nutrients was examined. Metabolic balance studies were also performed to discover how effectively these patients coul...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197510000-00007

    authors: Bradley EL 3rd,Isaacs J,Hersh T,Davidson ED,Millikan W

    更新日期:1975-10-01 00:00:00

  • Small amount of low-residue diet with parenteral nutrition can prevent decreases in intestinal mucosal integrity.

    abstract:OBJECTIVE:To investigate the suitable combination ratio of low-residue diet (LRD) and parenteral nutrition (PN) for nutritional support of surgical patients. SUMMARY BACKGROUND DATA:Bacterial translocation (BT) is a severe complication of total parenteral nutrition (TPN). However, it is sometimes impossible to supply ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200001000-00016

    authors: Omura K,Hirano K,Kanehira E,Kaito K,Tamura M,Nishida S,Kawakami K,Watanabe Y

    更新日期:2000-01-01 00:00:00

  • Use of extended criteria livers decreases wait time for liver transplantation without adversely impacting posttransplant survival.

    abstract:INTRODUCTION:The use of extended criteria donors (ECDs) could minimize shortage of suitable donor livers for transplantation. In 3 years, the aggressive use of ECD livers has reduced the wait list at our center from 257 to 30 patients with a median wait time of 18 days without using living donors. This study compares t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000234896.18207.fa

    authors: Tector AJ,Mangus RS,Chestovich P,Vianna R,Fridell JA,Milgrom ML,Sanders C,Kwo PY

    更新日期:2006-09-01 00:00:00

  • Effect of postdischarge morbidity and mortality on comparisons of hospital surgical quality.

    abstract:BACKGROUND:Hospitals increasingly rely on surgical quality assessment programs that require considerable resources to capture outcomes after hospital discharge. However, it is unclear whether capturing postdischarge complications and deaths is important. Our objectives were (1) to determine the frequency of postdischar...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181e4846e

    authors: Bilimoria KY,Cohen ME,Ingraham AM,Bentrem DJ,Richards K,Hall BL,Ko CY

    更新日期:2010-07-01 00:00:00

  • Prolonged Air Leak After Pulmonary Resection Increases Risk of Noncardiac Complications, Readmission, and Delayed Hospital Discharge: A Propensity Score-adjusted Analysis.

    abstract:OBJECTIVE:The aim of the study was to determine whether prolonged air leak (PAL) is associated with postoperative morbidity and mortality following pulmonary resection after adjusting for differences in baseline characteristics using propensity score analysis. SUMMARY BACKGROUND DATA:Patients with PAL after lung resec...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003191

    authors: Attaar A,Luketich JD,Schuchert MJ,Winger DG,Sarkaria IS,Nason KS

    更新日期:2021-01-01 00:00:00

  • Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair.

    abstract:OBJECTIVE:To evaluate the efficacy of mesh fixation with fibrin sealant (FS) in laparoscopic preperitoneal inguinal hernia repair and to compare it with stapled fixation. SUMMARY BACKGROUND DATA:Laparoscopic hernia repair involves the fixation of the prosthetic mesh in the preperitoneal space with staples to avoid dis...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200101000-00004

    authors: Katkhouda N,Mavor E,Friedlander MH,Mason RJ,Kiyabu M,Grant SW,Achanta K,Kirkman EL,Narayanan K,Essani R

    更新日期:2001-01-01 00:00:00

  • Fetus-in-fetu: An ususual cause for abdominal mass in infancy.

    abstract::Fetus-in-fetu is an unusual cause of retroperitoneal abdominal mass in infants, which most likely arises from inclusion of a monozygotic, diamniotic twin. This entity is distinguished from teratoma by its embryological origin, its unusual location in the retroperitoneal space, its invariable benignity, and by the pres...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197407000-00011

    authors: Grosfeld JL,Stepita DS,Nance WE,Palmer CG

    更新日期:1974-07-01 00:00:00

  • Laparoscopic liver resections: a feasibility study in 30 patients.

    abstract:OBJECTIVE:To assess the feasibility and safety of laparoscopic liver resections. SUMMARY BACKGROUND DATA:The use of the laparoscopic approach for liver resections has remained limited for technical reasons. Progress in laparoscopic procedures and the development of dedicated technology have made it possible to conside...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200012000-00004

    authors: Cherqui D,Husson E,Hammoud R,Malassagne B,Stéphan F,Bensaid S,Rotman N,Fagniez PL

    更新日期:2000-12-01 00:00:00

  • Diagnostic Accuracy of Different Surgical Procedures for Axillary Staging After Neoadjuvant Systemic Therapy in Node-positive Breast Cancer: A Systematic Review and Meta-analysis.

    abstract:OBJECTIVE:The aim of this study was to perform a systematic review and meta-analysis to assess the accuracy of different surgical axillary staging procedures compared with ALND. SUMMARY OF BACKGROUND DATA:Optimal axillary staging after neoadjuvant systemic therapy (NST) in node-positive breast cancer is an area of con...

    journal_title:Annals of surgery

    pub_type: 杂志文章,meta分析

    doi:10.1097/SLA.0000000000003075

    authors: Simons JM,van Nijnatten TJA,van der Pol CC,Luiten EJT,Koppert LB,Smidt ML

    更新日期:2019-03-01 00:00:00

  • Insulin treatment improves hepatic morphology and function through modulation of hepatic signals after severe trauma.

    abstract:OBJECTIVE:The purpose of the present study was to determine the effect of insulin therapy on hepatic function, structure, and hepatic mRNA and protein cytokine expression during the hypermetabolic cascade post burn. SUMMARY BACKGROUND DATA:Liver function and morphology are crucial for survival of patients suffering fr...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000133353.57674.cd

    authors: Klein D,Schubert T,Horch RE,Jauch KW,Jeschke MG

    更新日期:2004-08-01 00:00:00

  • Carcinoid tumors of the rectum: a multi-institutional international collaboration.

    abstract:OBJECTIVE:This study aims to describe recent experience with rectal carcinoids in European and North American centers. BACKGROUND:While considered indolent, the propensity of carcinoids to metastasize can be significant. METHODS:Rectal carcinoid patients were identified from prospective databases maintained at 9 inst...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0b013e3181fb8df6

    authors: Shields CJ,Tiret E,Winter DC,International Rectal Carcinoid Study Group.

    更新日期:2010-11-01 00:00:00

  • Effect of intravenous hyperalimentation on established delayed hypersensitivity in the cancer patient.

    abstract::Forty-seven cancer patients were selected for study based on their candidacy for hyperalimentation. Each patient received selected skin test antigens intradermally in the forearm prior to the initiation of hyperalimentation, and at 7-day intervals throughout treatment with either chemotherapy, radiation therapy or sur...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197607000-00010

    authors: Copeland EM,Fadyen BV Jr,Dudrick SJ

    更新日期:1976-07-01 00:00:00

  • Impaired mobility, ASA status and administration of tramadol are risk factors for postoperative delirium in patients aged 75 years or more after major abdominal surgery.

    abstract:OBJECTIVE:The aim of this prospective study was to determine incidence, duration, and risk factors for postoperative delirium (PD) in elderly patients undergoing major abdominal surgery. SUMMARY BACKGROUND DATA:The incidence and risk factors of PD after major abdominal surgery in elderly patients are not well document...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181c1cfc9

    authors: Brouquet A,Cudennec T,Benoist S,Moulias S,Beauchet A,Penna C,Teillet L,Nordlinger B

    更新日期:2010-04-01 00:00:00

  • Variation in Bariatric Surgery Episode Costs in the Commercially Insured: Implications for Bundled Payments in the Private Sector.

    abstract:OBJECTIVE:To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. BACKGROUND:Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002462

    authors: Kelsall AC,Cassidy R,Ghaferi AA

    更新日期:2018-12-01 00:00:00

  • Immune RNA therapy for renal cell carcinoma: survival and immunologic monitoring.

    abstract::Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eight...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197710000-00007

    authors: Ramming KP,deKernion JB

    更新日期:1977-10-01 00:00:00

  • Normoxic wound fluid contains high levels of vascular endothelial growth factor.

    abstract:OBJECTIVE:To examine the temporal integration of vascular endothelial growth factor (VEGF), which has been shown to be present in wound fluid, with the putatively related processes of wound fluid oxygen content, wound angiogenesis, and granulation tissue formation. SUMMARY BACKGROUND DATA:During cutaneous wound repair...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199811000-00011

    authors: Howdieshell TR,Riegner C,Gupta V,Callaway D,Grembowicz K,Sathyanarayana,McNeil PL

    更新日期:1998-11-01 00:00:00

  • A Longitudinal Assessment of Outcomes and Healthcare Resource Utilization After Immediate Breast Reconstruction-Comparing Implant- and Autologous-based Breast Reconstruction.

    abstract:OBJECTIVES:Immediate breast reconstruction (IBR) after mastectomy for cancer has increased in recent years, yet long-term, modality-specific comparative data are lacking. We performed this study to compare short- and long-term outcomes after expander, autologous (AT), and direct-to-implant (DI) breast reconstruction. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001457

    authors: Fischer JP,Fox JP,Nelson JA,Kovach SJ,Serletti JM

    更新日期:2015-10-01 00:00:00

  • Are positive axillary nodes in breast cancer markers for incurable disease?

    abstract:OBJECTIVE:This study was designed to determine if resection of positive regional nodes in patients with breast cancer provided a group of cured patients. SUMMARY BACKGROUND DATA:Previous studies of long-term follow-up of patients with breast cancer have demonstrated that 30% of patients with positive nodes may be aliv...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199309000-00006

    authors: Gardner B,Feldman J

    更新日期:1993-09-01 00:00:00

  • Influence of site of origin and mucin production on survival in ampullary carcinoma.

    abstract::We studied a series of 26 cases of carcinoma of the ampulla of Vater. There were 24 adenocarcinomas and two neuroendocrine tumors. Histologically the carcinomas could be divided into tumors arising from periampullary duodenal mucosa and those arising within the ampulla. True ampullary tumors had a significantly better...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198908000-00006

    authors: Dawson PJ,Connolly MM

    更新日期:1989-08-01 00:00:00

  • Angiopoietin-2, marker and mediator of endothelial activation with prognostic significance early after trauma?

    abstract:OBJECTIVE:To measure plasma levels of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) early after trauma and to determine their clinical significance. BACKGROUND:Angiopoietins and VEGF play a central role in the physiology and pathophysiology of endothelial cells. Ang-2 ha...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318162d616

    authors: Ganter MT,Cohen MJ,Brohi K,Chesebro BB,Staudenmayer KL,Rahn P,Christiaans SC,Bir ND,Pittet JF

    更新日期:2008-02-01 00:00:00

  • Acceleration of tensile strength of incisions treated with EGF and TGF-beta.

    abstract::The ability of surgeons to accelerate wound healing through pharmacologic intervention is limited. The effects of locally applied, biosynthetic human epidermal growth factor (EGF) and transforming growth factor-beta (TGF-beta) on tensile strength of experimental incisions were investigated. A single dose of EGF in sal...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198812000-00019

    authors: Brown GL,Curtsinger LJ,White M,Mitchell RO,Pietsch J,Nordquist R,von Fraunhofer A,Schultz GS

    更新日期:1988-12-01 00:00:00

  • Risk and location of cancer in patients with preoperative colitis-associated dysplasia undergoing proctocolectomy.

    abstract:OBJECTIVE:To evaluate the influence of preoperative dysplasia grade, appearance, and site on risk and location of cancer in patients with colitis. BACKGROUND:The ability to predict the presence and location of cancer in colitis patients with dysplasia is essential to facilitate recommendations regarding the necessity ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31828e7417

    authors: Kiran RP,Ahmed Ali U,Nisar PJ,Khoury W,Gu J,Shen B,Remzi FH,Hammel JP,Lavery IC,Fazio VW,Goldblum JR

    更新日期:2014-02-01 00:00:00