Response to neoadjuvant chemotherapy and effects of tumor regression in gastric cancer

Eur J Surg Oncol. 2006 Dec;32(10):1105-9. doi: 10.1016/j.ejso.2006.07.009. Epub 2006 Aug 22.


Aims: Aim of this study is the evaluation of the effects induced by neoadjuvant chemotherapy (NACT) and its impact on survival on a series of locally advanced gastric carcinomas.

Methods: Downstaging was assessed comparing pre-treatment clinical and laparoscopic staging with post-operative pathologic staging on 30 consecutive patients who completed a 3-year follow-up. Tumor downstaging and the grade of pathologic response were included in a statistical correlation between tumor regression induced by NACT and 3-year survival.

Results: In this series tumor downstaging was obtained in 13 out of 30 patients. After the completion of 3-year follow-up, overall survival was >37.5months with an overall survival rate of 56.7%; this figure reached up to 70.8% in those cases who benefited from a R0-resection (24/30 patients: R0-resection rate 80.0%).

Conclusions: In this study the 3-year survival for locally advanced gastric cancer treated by NACT prior to "D2" surgical resection, compares favourably with historical series treated by surgery alone. Patients who obtained T-downstaging and subsequently benefited from a R0-resection had a definitely better chance of cure, according to a complete 3-year follow-up.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Epirubicin / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Gastrectomy*
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Neoadjuvant Therapy*
  • Prognosis
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Survival Rate


  • Epirubicin
  • Etoposide
  • Cisplatin

Supplementary concepts

  • EEP protocol