KẾT QUẢ CỦA HOÁ TRỊ TÂN HỖ TRỢ VỚI PHÁC ĐỒ DOCETAXEL, CISPLATIN, VÀ S-1 THEO SAU BẰNG PHẪU THUẬT TRONG ĐIỀU TRỊ UNG THƯ DẠ DÀY DI CĂN HẠCH BULKY

Abstract

Introduction: Bulky lymph node metastasis in gastric cancer (GC) is considered an unresectable stage with a poor survival prognosis. Neoadjuvant chemotherapy followed by gastrectomy may improve survival outcomes. This study analyzed the efficacy of neoadjuvant chemotherapy with the DCS regimen followed by gastrectomy and radical lymphadenectomy for GC with bulky lymph node metastasis. Methods: A total of 26 patients with bulky lymph node metastasis from GC underwent chemotherapy, of which 18 patients underwent radical gastrectomy from January 2018 to June 2022 at the Department of Gastrointestinal Surgery, University Medical Center Ho Chi Minh City. Clinical data, including disease characteristics, response rate, toxicity, surgical outcomes, and survival rates, were collected and analyzed. Results: The response rate after neoadjuvant chemotherapy was 22 out of 26 patients (84.6%). Most chemotherapy toxicities were mild, with grade 3-4 toxicities including neutropenia (3.8%), anemia (7.7%), and thrombocytopenia (3.8%). Of the 18 patients who underwent surgery, 17 out of 18 (94.4%) achieved R0 resection. There were no severe complications in any of the patients who underwent surgery. The 3-year overall survival rate was 54.8%, and the 3-year disease-free survival rate was 40.9%. Conclusion: Neoadjuvant chemotherapy with the DCS regimen followed by radical gastrectomy demonstrated low chemotherapy toxicity, a high clinical response rate, safe surgical outcomes, and favorable survival rates.