Examination of Utility of Short-termed Neoadjuvant Chemotherapy for Advanced Gastric Cancer: Study from Viewpoints of Apoptosis Induction and Cell Growth

Yoshifumi Sogo, Motohiro Imano, Hitoshi Shiozaki and Harumasa Ooyanagi

Department of Surgery, Kinki University School of Medicine

Purpose: We reviewed the effect of short-term neoadjuvant chemotherapy (s-NAC) in resected primary gastric lesions and metastatic lymph node postoperatively in patients with advanced gastric cancer. Materials and methods: We preoperatively classified 98 patients with advanced gastric cancer into 4 groups, i.e., 5-FU administration alone for 20 (group F), CDDP administration alone for 15 (group C), and both 5-FU and CDDP for 34 (group FC). Nothing was administered to 29 serving as the control group. s-NAC was conducted 3 days preoperatively. We studied apoptosis induction, cell growth in primary lesions and metastatic lymph nodes for each group, and expression of the apoptosis-associated gene on primary lesions. We also studied micrometastasis using an anticytokeratin antibody in lymph nodes. Results: Group FC showed apoptosis and restrained cell growth in primary gastric lesions and metastatic lymph nodes, with changes significantly higher than in other groups. p53 wild type, p21, and Bax expression were observed significantly highly positively in group FC. Significantly increased micrometastasis in lymph nodes was detected in group FC although fewer metastases were recognized in HE staining. Conclusions: s-NAC in advanced gastric cancer reduced lymph node metastasis recognized in HE staining to micrometastasis by extensively inducing apoptosis and depressing cell growth more in group FC than in groups F and C.

Key words
advanced gastric cancer, neoadjuvant chemotherapy, apoptosis, micrometastasis, FP therapy

Reprint requests
Motohiro Imano Department of Surgery, Kinki University School of Medicine
377-2 Ono-Higashi, Osaka-Sayama, 589-8511 JAPAN

Accepted
November 30, 2004

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