Trial reportGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2019
An integrated analysis of two phase II trials (JCOG0001 and JCOG0405) of preoperative chemotherapy followed by D3 gastrectomy for gastric cancer with extensive lymph node metastasis.
Trial report in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 43 citations in OpenAlex.
- Indocyanine green fluorescence imaging-guided versus conventional laparoscopic lymphadenectomy for gastric cancer: long-term outcomes of a phase 3 randomised clinical trial.Nature communications · 2023Trial
- Neoadjuvant FLOT versus SOX phase II randomized clinical trial for patients with locally advanced gastric cancer.Nature communications · 2020Trial
- Robotic para-aortic lymph node dissection via the left renal vein as the starting point.Surgery today · 2026Article
- Preoperative chemotherapy with a modified docetaxel, cisplatin, and S-1 regimen, followed by gastrectomy and lymphadenectomy for gastric cancer with bulky lymph nodes.Surgery today · 2026Article
- Re-evaluation of lymph node dissection and surgical strategy for locally advanced gastric cancer in the era of neoadjuvant immunotherapy: a narrative review.Frontiers in oncology · 2026Review
- Swollen lymph node metastasis and survival in gastric cancer: Multi-institutional post-resection analysis.World journal of clinical oncology · 2025Article
- The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2023.Cancer communications (London, England) · 2024Article
- The Clinical Implication of Conversion Surgery in Patients with Stage IV Gastric Cancer Who Received Systemic Chemotherapy.Biomedicines · 2023Article
- Extended Lymphadenectomy for Gastric Cancer in the Neoadjuvant Era: Current Status, Clinical Implications and Contentious Issues.Current oncology (Toronto, Ont.) · 2023Review
- Changes in Oncological Surgical Principles Driven by Advances in Preoperative Treatments.Therapeutics and clinical risk management · 2023Article
- The efficacy and safety of continuous intra-arterial infusion neoadjuvant chemotherapy with surgery for locally advanced gastric cancer: a preliminary pilot study.Journal of gastrointestinal oncology · 2022Article
- Prognostic factors in patients who received paraaortic lymph node dissection for locally advanced gastric cancer with extensive lymph node metastasis.Langenbeck's archives of surgery · 2022Article
- Current status of conversion surgery for stage IV gastric cancer.Surgery today · 2021Review
- The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2021.Cancer communications (London, England) · 2021Article
- History and emerging trends in chemotherapy for gastric cancer.Annals of gastroenterological surgery · 2021Review
- Lymph Node Involvement in Advanced Gastric Cancer in the Era of Multimodal Treatment-Oncological and Surgical Perspective.Cancers · 2021Review
- Current status and future perspectives on neoadjuvant therapy in gastric cancer.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2021Article
- An unresectable gastric cancer with bulky lymph node metastases treated with SOX chemotherapy plus apatinib followed by D3 radical gastrectomy: a case report.Translational cancer research · 2021Article
- Is D2 Lymphadenectomy Alone Suitable for Gastric Cancer With Bulky N2 and/or Para-Aortic Lymph Node Metastases After Preoperative Chemotherapy?Frontiers in oncology · 2021Article
- A case of stage IV gastric cancer with para-aortic lymph node metastasis showing pathological complete response after neoadjuvant chemotherapy.Surgical case reports · 2020Article
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Authors and funding
10 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGastric cancer with extensive lymph node metastasis is commonly regarded as unresectable, while preoperative chemotherapy followed by gastrectomy has been tested since 2000 in JCOG (JCOG0001 and JCOG0405). The survivals were quite different between the trials despite the similar eligibility criteria. The aim of this study was to investigate if survival is still better in JCOG0405 after adjusting baseline factors and if there is any subset of patients who benefit more from either treatment.
methodsEligibility criteria for both trials included histologically proven gastric adenocarcinoma; bulky nodal involvement around the celiac artery and its major branches (bulky N) and/or para-aortic lymph node (PAN); cM0 (except PAN); negative lavage cytology; not linitis plastica type; PS of 0 or 1. Patients received two or three cycles of preoperative chemotherapy of irinotecan plus cisplatin in JCOG0001, or S-1 plus cisplatin in JCOG0405, followed by D3 gastrectomy. Multivariable analysis for overall survival adjusting baseline and treatment factors was performed with the Cox regression model.
resultsAfter adjusting baseline factors, S-1 plus cisplatin was superior to irinotecan plus cisplatin for overall survival (HR = 0.39: 95% CI 0.22-0.67). The 5-year overall survival was poor for patients with bulky N+/PAN+ (19.2%) compared with bulky N+/PAN- (50.7%) or bulky N-/PAN+ (43.5%).
conclusionsS-1 plus cisplatin was shown to be a favorable preoperative treatment for gastric cancer with extensive lymph node metastasis by multivariable analysis, while poor prognosis in patients having both bulky N+ and PAN+ may necessitate further treatment improvement.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.