Preoperative chemotherapy with a modified docetaxel, cisplatin, and S-1 regimen, followed by gastrectomy and lymphadenectomy for gastric cancer with bulky lymph nodes.
| Title: | Preoperative chemotherapy with a modified docetaxel, cisplatin, and S-1 regimen, followed by gastrectomy and lymphadenectomy for gastric cancer with bulky lymph nodes. |
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| Authors: | Long VD; Department of Gastro-Intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. long.vd@umc.edu.vn.; Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. long.vd@umc.edu.vn.; University Medical Center at Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam. long.vd@umc.edu.vn.; Thong DQ; Department of Gastro-Intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Dat TQ; Department of Gastro-Intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Nguyen DT; Department of Gastro-Intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Tho TV; Department of Oncology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Phuoc TD; Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Hai NV; Department of Gastro-Intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Vuong NL; Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Trung LQ; Department of Oncology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Bac NH; Department of Gastro-Intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. |
| Source: | Surgery today [Surg Today] 2026 Feb; Vol. 56 (2), pp. 195-206. Date of Electronic Publication: 2025 Aug 25. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer International Country of Publication: Japan NLM ID: 9204360 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1436-2813 (Electronic) Linking ISSN: 09411291 NLM ISO Abbreviation: Surg Today Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Tokyo : Springer International, c1992- |
| MeSH Terms: | Stomach Neoplasms*/pathology ; Stomach Neoplasms*/mortality ; Stomach Neoplasms*/therapy ; Stomach Neoplasms*/surgery ; Gastrectomy*/methods ; Antineoplastic Combined Chemotherapy Protocols*/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols*/adverse effects ; Antineoplastic Combined Chemotherapy Protocols*/therapeutic use ; Lymph Nodes*/pathology ; Preoperative Care*/methods ; Neoadjuvant Therapy*/methods ; Lymph Node Excision*; Docetaxel/administration & dosage ; Cisplatin/administration & dosage ; Tegafur/administration & dosage ; Oxonic Acid/administration & dosage ; Humans ; Male ; Drug Combinations ; Female ; Middle Aged ; Aged ; Adult ; Treatment Outcome ; Survival Rate ; Combined Modality Therapy ; Lymphatic Metastasis |
| Abstract: | Purpose: The appropriate regimen and dosage of preoperative chemotherapy for gastric cancer (GC) with bulky lymph nodes (LNs) remain controversial. We conducted this study to evaluate the efficacy of preoperative chemotherapy using a modified regimen of docetaxel, cisplatin, and S-1 (DCS) for GC with bulky LNs, assessing feasibility, toxicity, response rate, and oncological outcomes.; Methods: Thirty-two patients who had GC with bulky LNs diagnosed between Jan, 2018 and Oct, 2022 received three or four cycles of modified DCS regimen preoperatively. The primary outcome was 3 year overall survival (OS).; Results: The completion rate of preoperative chemotherapy was 90.6% (4 cycles: 50.0%, 3 cycles: 40.6%). The disease control rate (DCR) and clinical response rate (RR) were 87.5% and 81.3%, respectively. Grade-3/4 neutropenia and anemia developed in 6.2% and 9.4%, respectively. Twenty-two patients with partial response (PR) agreed to undergo gastrectomy and LN dissection. Pathologic complete response (CR) was achieved in 15.6%. After surgery, there were no grade > = 3 postoperative complications. The R0-resection rate was 65.6%. The 3 year OS and progression-free survival (PFS) rates were 43.0% and 37%, respectively, for all eligible patients. The 3 year OS and PFS of patients in the surgery group with negative para-aortic LNs were 58% and 47.0%, respectively.; Conclusion: Preoperative chemotherapy with a modified DCS regimen demonstrated high tolerance, a clinical response rate, and satisfactory 3 year survival outcomes. Thus, a preoperative modified DCS regimen with 3-4 cycles is a promising approach for GC with bulky LNs.; (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Conflict of interest: Drs. Vo Duy Long, Dang Quang Thong, Tran Quang Dat, Doan Thuy Nguyen, Tran Vinh Tho, Tran Duy Phuoc, Nguyen Viet Hai, Nguyen Lam Vuong, Lam Quoc Trung, and Nguyen Hoang Bac disclose no potential or actual personal, political or financial conflict of interest in the material, information, or techniques described in the paper. Ethical approval: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by Institutional Review Board, University Medical Center Ho Chi Minh city. Approval to perform research on human subjects in this study was provided by the Institutional Review Board, University Medical Center Ho Chi Minh city (registration number: 37/HDDD-DHYD). |
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| Contributed Indexing: | Keywords: Bulky lymph nodes; Clinical response rate; DCS regimen; Gastric cancer; Preoperative chemotherapy |
| Substance Nomenclature: | 15H5577CQD (Docetaxel); Q20Q21Q62J (Cisplatin); 1548R74NSZ (Tegafur); 5VT6420TIG (Oxonic Acid); 150863-82-4 (S 1 (combination)); 0 (Drug Combinations) |
| Entry Date(s): | Date Created: 20250825 Date Completed: 20260202 Latest Revision: 20260205 |
| Update Code: | 20260205 |
| PubMed Central ID: | PMC12864211 |
| DOI: | 10.1007/s00595-025-03114-x |
| PMID: | 40855039 |
| Database: | MEDLINE |
Journal Article