Loading...
2 results
Search Results
Now showing 1 - 2 of 2
- Impact of perioperative chemotherapy on postoperative morbidity after gastrectomy for gastric cancerPublication . Cabral, Francisco; Ramos, Paulo; Monteiro, Cecília; Casaca, Rui; Pinto, Iola; Abecasis, NunoIntroduction: The use of perioperative chemotherapy (CT) in patients with advanced gastric carcinoma increases their overall survival. This therapy may also increase the number of patients with R0 resection. Potential drawbacks of this therapy, besides its toxicity, include increased surgical morbidity. Methods: We retrospectively evaluated the records of patients undergoing gastrectomy with curative intent, for carcinoma, at our institution between January 2009 and August 2018. They were divided into two groups: direct surgery (SURG) and perioperative CT (CHEMO). Patients with other neoadjuvant therapies and cardia Siewert I and II carcinomas were excluded. The primary objective was to evaluate the impact of perioperative CT on surgical morbidity. As secondary objectives, resection radicality and total lymph node count were compared between the two groups. Results: A total of 307 patients (97 direct surgery and 210 perioperative CT) were evaluated. Median age was 67 years old. The overall major surgical morbidity (Clavien-Dindo 3-5) was 10.6% in the CHEMO group and 12.4 in the SURG group (p = 0.643). There was no statistically significant difference between the surgical radicality (R0 98% in the SURG group vs 97.5% CHEMO group (p = 0.865). There was an increase in the total number of lymph nodes retrieved in the specimen in the CHEMO group (25 vs 22, p = 0.001), a difference that was not maintained in the subgroup analysis as a function of the surgery performed. Conclusions: Perioperative CT in gastric carcinoma does not increase surgical morbidity, surgical radicality and total lymph node count. (C) 2020 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.
- Complete pathological response (pCR) in gastroesophageal cancer: Correlation with metabolic responsePublication . Cabral, Francisco; Cruz, A.; Casaca, R.; Monteiro, C.; Ramos, P.; Pedro, C.; Brandão, F.; Fonseca, R.; Ratão, P.; Saldado, L.; Pinto, Iola; Abecasis, N.Purpose. - Neoadjuvant chemoradiotherapy (nCRT) followed by surgery in patients with resectable esophageal or esophagogastric junctional (GEJ) (Siewert I) cancer is associated with long term overall survival benefits. Up to one third of all patients submitted to nCRT present pathological complete response (pCR). F-18-fluorodeoxyglucose positron emission tomography with CT (F-18-FDG PET-CT) is an important tool for assessing treatment response. Purpose was to assess retrospectively the power of F-18-FDG PET-CT in predicting pCR to evaluate the feasibility of a "watch and wait" approach. Patients and methods. - Retrospective analysis of a prospective database with esophageal or GEJ submitted to pre-operative chemoradiation. Pre and pos treatment F-18-FDG PET-CT were reviewed and classified using visual assessment and PERCIST criteria and the values of maximum standard uptake value were also recorded. Patients were classified as pCR or non-PCR. F-18-FDG PET-CT and pathological findings were compared against each other. Results. - Forty-three patients were included. The median age was 67 years and 90.7% were male. All patients underwent preoperative CRT and were evaluated with F-18-FDG PET-CT pre and post treatment. Transthoracic surgery was performed in all patients. Histological type was adenocarcinoma in 37% and squamous cell carcinoma in 58%. pCR was achieved in 56% of cases. Visual assessment of F-18-FDG PET-CT showed overall sensitivity 57.9%, specificity 62.5% and PERCIST criteria had 100% sensibility and 16.7% specificity. Conclusions. - F-18-FDG PET-CT is not an ideal predictor of pCR but if we use the PERCIST criteria we will have a high sensitivity and negative predictive value, avoiding false negative scans. (C) 2020 Societe francaise de radiotherapie oncologique (SFRO).