A Histological and Cytological Effect of Preoperative Chemotherapy for Advanced Gastric Cancer -Evaluation of the Combination Chemotherapy with 5FUand Low Dose CDDP-

Hirofumi Suzuki

First Department of Surgery, Chiba University

To evaluate the effects of preoperative chemotherapy for advanced gastric cancer, we examined the histopathological effects, the changes in the nuclear area (NA) and the coefficient of variation (NACV) of residual cancer cells. Thirty patients were treated by continuous i. v.5FU injection (300 mg/m²/day) until the day before the operation (FU group). Forty-two patients were treated with C. I.V 5FU by i. v. injection of low a dose of CDDP (15 mg/m²/day) on day 1 and 2 (CF group). These compared with two groups were given a no treatment group (20 cases). According to the Japanese classification of gastric carcinoma, the histological effects were as follow: FU group (Gr0, 9; Gr1a, 13; Gr1b, 5 and Gr2, 3.) and CF group (Gr0, 10; Gr1a, 21; Gr1b, 5; Gr2, 5; and Gr3, 1.). These were no nignificant histological differences between the FU and CF groups. The values of NA were as follows: control (47. 6μ m²), FU group (Gr0, 50.5; Gr1a, 58.8; Gr1b, 65.2; and Gr2, 72.6.) and CF group (Gr0, 70.2; Gr1a, 64.2; Gr1b, 49.8; and Gr2, 33.8.). The values of NACV were as follows: control (27.0%), FU group (Gr0, 27.9; Gr1a, 30.7; Gr1b, 38.4; and Gr2, 30.5.) and CF group (Gr0, 32.1; Gr1a, 34.6; Gr1b, 50.8; and Gr2, 50.3.). Low a dose CDDP causes a decrease in NA and an increase in NACV in patients with a high-grade response to preoperative 5FU chemotherapy. These findings suggest that a valuation of NA and NACV in useful for the prediction of chemosensitivity and that low a dose CDDP is an important factor as not only an effector but also a modulator in biochemicall modulation of 5FU chemotherapy.

Key words
gastric cancer, preoperative chemotherapy, combination chemotherapy with 5FU and low dose CDDP, biochemical modulation

Reprint requests
Hirofumi Suzuki Department of Surgery, National Cancer Center Hospital East 6-5-1 Kashiwanoha, Kashiwa, 277-8577 JAPAN

Accepted
December 9, 1998

To read the PDF file you will need Abobe Reader installed on your computer.