Analysis of patients with locally advanced gastric cancer undergoing gastrectomy after pre-operative chemotherapy including S-1

To improve the prognosis of advanced gastric cancer, various adjuvant therapies were tried. We retrospectively examined 7 cases of gastrectomy after pre-operative chemotherapy using S-1 +CDDP, and reported its effectiveness and the result. An adverse event of more than Grade 3 showed neutropenia in two cases. Anti-tumor effect on the imaging was found in 6 cases of PR and one case of SD. We performed gastrectomy within 4 weeks after completion of chemotherapy in each case. The histological antitumor effect was more than Grade 2 in four cases, but there was no complete response. We compared the overall survival of a patient of more than Grade 2 by histological antitumor effect under grade 1 b. In the former, MST was 982 days and the two-year survival rate was 50.0%; in the latter, MST was 443 days and the two-year survival rate was 33.3%. We can perform pre-operative chemotherapy using S-1+CDDP and expect prognostic improvement for a histologically effective case of chemotherapy. If the utility of preoperative chemotherapy mainly with S-1 is proved in a phase III trial, this would appear to be a therapy of choice for advanced gastric cancer in future.