Exploratory phase II trial in a multicenter setting to evaluate the clinical value of a chemosensitivity test in patients with gastric cancer (JACCRO-GC 04, Kubota memorial trial).

Background: Although postoperative adjuvant chemotherapy with S-1, an oral fluoropyrimidine, has become a standard of care for gastric cancer in Japan, nonresponders may suffer from the cost and adverse reactions without clinical benefit. This multicenter exploratory phase II trial was conducted to see whether a chemosensitivity test, the collagen gel droplet embedded culture drug sensitivity test (CD-DST), can adequately select patients for chemotherapy.

Methods: The CD-DST using four different concentrations of 5-fluorouracil was conducted with resected specimens from preregistered patients who underwent gastrectomy with D2 or more extensive lymphadenectomy.

Optimal Roux-en-Y reconstruction after distal gastrectomy for early gastric cancer as assessed using the newly developed PGSAS-45 scale.

Purpose: The optimal surgical procedure for distal gastrectomy with Roux-en-Y reconstruction (DGRY) remains to be determined. Recently, a self-report assessment instrument, the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45), was compiled to evaluate symptoms, the living status and the quality of life of patients who have undergone gastrectomy. We used this scale to evaluate procedures used for DGRY.

Evaluation of QOL after proximal gastrectomy using a newly developed assessment scale (PGSAS-45).

Background: Proximal gastrectomy with esophagogastrostomy (PGEG) has been widely applied as a comparatively simple method. In this study, we used a questionnaire survey to evaluate the influence of various surgical factors on post-operative quality of life (QOL) after PGEG.

Methods: In this post-gastrectomy syndrome assessment study, we analyzed QOL in 2,368 cases.

Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 and changes in body weight are useful tools for evaluation of reconstruction methods following distal gastrectomy.

Background: Billroth-I (BI) and Roux-en-Y (RY) are well-known reconstruction methods that are conducted following distal gastrectomy. However, the relative merits of these 2 methods are not well documented. The newly developed Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 is an integrated questionnaire consisting of 45 items, including 8 items from the 8-Item Short-Form Health Survey (SF-8), 15 items from the Gastrointestinal Symptom Rating Scale, and 22 items selected by gastric surgeons.

Phase II study of mitomycin C, cisplatin and 5-fluorouracil for advanced and recurrent gastric cancer.

In this study, we assessed the efficacy and feasibility of a 5-FU, MMC and cisplatin combination in patients with advanced or recurrent gastric cancer. 5-FU was administered at a dose of 360 mg/m2 on days 1 through 5 and days 8 through 12. CDDP was administered at a dose of 7 mg/m2 on days 1 through 5 and days 8 through 12.

D2-lymphadenectomy improves the survival of patients with peritoneal cytology-positive gastric cancer.

Background: According to the current Japanese Classification of Gastric Cancer, patients with peritoneal cytology-positive (CY1) gastric cancer are classified as stage IV and the curative potential of resection for these patients is regarded as non-curative.

Materials And Methods: We compared the clinical outcome of CY1 patients (n=55) with those of patients with other non-curative factors (n=87), to clarify the optimal surgical strategy for CY1 patients.

Results: The 5-year survival rate of CY1 patients was 10.

Long-term postoperative survival of a gastric cancer patient with numerous para-aortic lymph node metastases.

A56-year-old man with advanced gastric cancer was referred to our hospital. Preoperative abdominal computed tomography revealed numerous enlarged lymph nodes, including the lymph nodes of the paraaortic region. The patient underwent total gastralectomy, splenectomy, left-adrenalectomy and resection of the body and tail of the pancreas by Appleby's method, along with paraaortic lymph node dissection.