Gastric cancer is the most common malignancy in Korea. Cure for patients with gastric carcinoma can be achieved only by radical surgery. From August 1988 to May 1992, 25 patients with locally advanced unresectable gastric cancer received 5-FU(Fluorouracil) + adriamycin + mitomycin-c or 5-FU+cisplatin based induction chemotherapy before surgery. The partial response rate after median 3 cycles of induction chemotherapy was 52%. Stable disease 12%. Progressive disease 36%. Gastric resection was performed in 18 patients(72%); 13 patients(52%) underwent radical surgery and 5 patients(20%) underwent palliative surgery. Median survival of the patients who underwent curative and palliative surgery was 24.4 and 27 months, respectively. However, median survival of the patients who didn't undergo any surgery was only 6.5 months. The dirference of median survival between curative surgery and none surgery group were significant statistically(p<0.03). Side effects of induction chemotherapy were acceptable and there were no life threatening toxicities In this study, half of the patients can undergo curative surgery after induction chemotherapy. We observe the long term survival in some patients after induction chemotherapy and surgery in loco-regionally advanced gastric cancer.
This therapeutic approch for the locally advance stomach cancer seems to be feasible. But, prospective randomized clinical trial is warranted in the future.