KẾT QUẢ ĐIỀU TRỊ UNG THƯ DẠ DÀY BẰNG PHẪU THUẬT KẾT HỢP HÓA CHẤT TRƯỚC MỔ TẠI BỆNH VIỆN K

Abstract

Objective: To evaluate the treatment outcomes of advanced gastric cancer patients who received surgery combined with preoperative chemotherapy at K Hospital. Subjects and methods: A retrospective descriptive study of 52 patients diagnosed with stage III-IV unresectable gastric carcinoma at baseline, treated with neoadjuvant chemotherapy and operated from January 2018 to June 2023 at K Hospital. Results: The average age of patients was 59.3 years old with 53.8% of patients aged 40 to 60, the majority of patients (73.1%) were male. Common symptoms included epigastric pain (80.8%), weight loss (73.1%), anorexia (51.9%) and vomiting, nausea (28.8%). The main physical symptoms were anemia (13.5%), palpable lymph nodes (11.5%), and hematemesis and black stools (9.6%). Patients with tumor lesions in the antrum accounted for the highest proportion with 73.1%. Tumor size from 1-3 cm accounted for the majority with 40.4%, ulcer type accounted for the highest proportion with 42.3%. The majority of patients were treated with the FLOT regimen, accounting for 90.4%; 5 patients were treated with the XELOX regimen, accounting for 9.6%. Patients with partial response were 98.1%. 84.6% of patients had subtotal gastrectomy, 13.5% had total gastrectomy, and 1.9% had extended gastrectomy. The median overall survival was 16.2 months. The overall survival rates at 2 years and 5 years were 76.9% and 13.5%, respectively. The 5-year overall survival rates of patients with N1, N2, and N3a lymph node metastases were 27.3%, 10.3%, and 8.3%, respectively. The difference in overall survival rates between the N1, N2, and N3a groups was significant with p <0.05 (p=0.026). Conclusion: Preoperative chemotherapy prolongs overall survival, increases the rate of gastrectomy, and does not increase postoperative complications for patients.