[Adjuvant chemotherapy in gastric cancer. Experience at the National Institute of Nutrition]

Abstract

The cases of gastric carcinoma treated with surgery plus chemotherapy (FAM) at the Instituto Nacional de la Nutricion (INNSZ) in Mexico City from January 1979 to December 1988 were reviewed. In 322 patients seen in this period, only in 12.4% (40 patients) it was possible to undertake curative resection; of these, twenty two received adjuvant FAM (fluorouracil, 600 mg/m2 IV days 1,2,3; doxorubicin, 30-35 mg/m2 day 1; and mitomycin-C, 10 mg/m2 in three days). Twenty patients were in stage III and two in stage II. At a median follow-up of five years, ten patients have relapsed; of these, eight died from progressive neoplasia; one is alive with no evidence of disease 24 months after receiving combined chemotherapy with 5-fluorouracil, cisplatinum and adriamycin, and one is alive with the disease. Nine patients (40.5%) are alive with no evidence of relapse 30 to 114 months after initial surgery. One patient died from unrelated causes with no evidence of relapse. Two individuals were lost to follow up at 9 months and 28 months, without evident malignant disease at the time of last consultation. The median survival was 61 months with a 51% estimated overall survival at five years. None of the prognostic factors analyzed were significantly associated with recurrence: number of metastatic lymph nodes; number of cycles of chemotherapy; interval between surgery and chemotherapy; and intraoperative blood transfusions requirements, although there was a tendency to relapse in the majority of the patients who received intraoperative blood transfusions as compared with the untransfused (five years disease free survival of 18% vs 64% respectively).(ABSTRACT TRUNCATED AT 250 WORDS)