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Title   수술 전 화학요법을 시행한 진행성 위암의 병리학적 관찰 ( Pathological Observation in Locally Advanced Gastric Carcinomas after Preoperative Chemotherapy )
Publicationinfo   1992 Jan; 024(04): 541-549.
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Abstract   Neoadjuvant chemotherapy on locally advanced unresectable gastric cancers is recently con- sidered to be benificial to downstaging of tumors and better chance of curative resection. This study was aimed to describe morphologic alterations in gastric adenocarcinomas after chemo- therapy and discuss their clinical significances. Thirty two cases to advanced #Rastric carcinomas which were surgically resected after 2-3 cycles of chemotherapy with C-DDP/VP-16/5-FU (PEF) were reviewed. The patients were initially diagnosed by endoscopic biopsies, and staged through radiologic studies as unresectable cases without distant metastasis. On microscopic examination, 19 cases (59%) revealed major pathologic alterations. Four cases showed pathologic complete remission, histologically resembling healed or active peptic ulcers. The most common histologic changes, observed in 14 cases, were dense fibroses with a decrease in tumor cellularity, which were more frequent in poorly differentiated than in moderately differentiated tubular adenocarcinoma. The changes were also observed in metastatic tumors in regional lymph nodes of 6 cases. One case of mucinous carcinoma was totally composed of acellular mucin pools both in primary and metastatic lesions. Twenty one patients (68%) revealed T and /or N downstaging, more frequently with poorly differentiated adenocarcinomas. But the presence of patholagic alterations and of downstagins effect did not correlate each other. Accurate assessment of chemotherapy response is dependent on careful clinical studies and thorough histological examination of the resected specimens. Our data suggest that PEF neoadjuvant chemotherapy far locally advanced gastric carcinoma is feasible, and additional studies to achieve more frequent pathologic response may be warranted.
저 자   조경자(Kyung Ja Cho),장자준(Ja June Jang),하창원(Chang Won Ha),고재수(Jae Soo Koh),이종인(Jong Inn Lee),최동욱(Dong Wook Choi),강윤구(Keun Chil Park)