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International Journal of Surgical Oncology
Volume 2018 (2018), Article ID 9371492, 6 pages
https://doi.org/10.1155/2018/9371492
Research Article

Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade

1University of Adelaide Discipline of Surgery, The Queen Elizabeth Hospital, Woodville, Adelaide, SA, Australia
2Division of Surgery, The Queen Elizabeth Hospital, Woodville, Adelaide, SA, Australia

Correspondence should be addressed to Harsh Kanhere

Received 26 September 2017; Accepted 27 November 2017; Published 14 January 2018

Academic Editor: Theodore D. Liakakos

Copyright © 2018 Harsh Kanhere et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives. Most gastric cancer patients now undergo perioperative chemotherapy (POCT) based on the MAGIC trial results. POCT consists of neoadjuvant chemotherapy (NACT) as well as postoperative adjuvant chemotherapy. This study assessed the applicability of perioperative chemotherapy and the impact of radical gastrectomy encompassing a detailed lymph-node resection on outcomes of gastric cancer. Methods. Medical and pathology records of all gastric carcinoma resections were reviewed from 2006 onwards. Pathological details, number of lymph-nodes resected, and proportion of involved nodes, reasons for nonadministration of NACT, complications, recurrence, and survival data were analysed. Results. Only twenty-eight (37.8%) out of 74 patients underwent NACT and only nine completed POCT. NACT was declined due to comorbidities/patient refusal , early stage , and emergency presentation . Patients receiving NACT were much younger. Anastomotic leaks, hospital-mortality, lymph-node yield, and proportion of involved lymph-nodes were similar in both groups. Thirty-two patients died due to recurrence with lymph-node involvement heralding higher recurrence risk and much poorer survival (HR 2.66; ). Conclusion. More than 60% patients with resectable gastric carcinoma did not undergo NACT. Radical gastrectomy with lymphadenectomy remained the cornerstone of treatment in this period.