Furthermore , this therapy could increase the dem and on radiation re sources .
There is no evidence on which to make a recommendation for patients with node-negative tumours that have not penetrated the muscularis propria .
For patients unable to undergo radiation , adjuvant chemotherapy alone may be of benefit , particularly for those with lymph-node metastases .
There is insufficient evidence from r and omized trials to recommend neoadjuvant chemotherapy , or neoadjuvant or adjuvant radiotherapy or immunotherapy , either alone or in combination , outside a clinical trial .
OBJECTIVE To make recommendations on the use of neoadjuvant or adjuvant therapy in addition to surgery in patients with resectable gastric cancer ( T1 - 4 , N1 - 2 , M0 ) .
OPTIONS Neoadjuvant or adjuvant treatments compared with " curative " surgery alone .
OUTCOMES Overall survival , disease-free survival , and adverse effects .
The radiation fields used can possibly damage the left kidney , result ing in hypertension and other renal problems .
Upper abdominal stop-flow perfusion as a neo and adjuvant hypoxic regional chemotherapy for resectable gastric carcinoma. A prospective randomized clinical trial.
BACKGROUND / AIMS Gastric cancer remains a disease with a poor and dismal prognosis even after radical surgical resection . The present study attempts to clarify whether neo and adjuvant hypoxic upper abdominal chemotherapy can improve the survival of patients with gastric cancer undergoing radical surgical resection . Patterns of failure after surgery for gastric cancer include peritoneal seeding , resection margin recurrence , and liver metastasis . METHODOLOGY From October 1995 to February 1999 , 58 patients with resectable gastric cancer were r and omly assigned to three groups . Hypoxic upper abdominal chemotherapy was carried out using Mitomycin-C , 5-Fluorouracil , Leucovorin , and Farmorubicin , 10 days before surgery , and 20 days following surgery , in Group A ( n=20 ) with or without in Group B ( n=19 ) systemic chemotherapy ; the remaining patients ( Group C : n=19 ) had neither neo nor adjuvant treatment . RESULTS The 4-year survival of Group C patients was 29.2 % . Group A patients ( surgery plus hypoxic neo and adjuvant chemotherapy and systemic chemotherapy ) had a 4-year survival of 45.5 % versus a 4-year survival of 39.2 % of Group B patients ( surgery and hypoxic neo and adjuvant abdominal perfusion ) . Patients of all stages , histologically confirmed , were included in this study . CONCLUSIONS Patients suffering from gastric carcinoma have demonstrated statistically improved survival by combining resectional surgery with neo and adjuvant hypoxic upper abdominal perfusion and adjuvant systemic chemotherapy
Furthermore , this therapy could increase the dem and on radiation re sources .
There is no evidence on which to make a recommendation for patients with node-negative tumours that have not penetrated the muscularis propria .
For patients unable to undergo radiation , adjuvant chemotherapy alone may be of benefit , particularly for those with lymph-node metastases .
There is insufficient evidence from r and omized trials to recommend neoadjuvant chemotherapy , or neoadjuvant or adjuvant radiotherapy or immunotherapy , either alone or in combination , outside a clinical trial .
OBJECTIVE To make recommendations on the use of neoadjuvant or adjuvant therapy in addition to surgery in patients with resectable gastric cancer ( T1 - 4 , N1 - 2 , M0 ) .
OPTIONS Neoadjuvant or adjuvant treatments compared with " curative " surgery alone .
OUTCOMES Overall survival , disease-free survival , and adverse effects .
The radiation fields used can possibly damage the left kidney , result ing in hypertension and other renal problems .