gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Results of secondary resection after responding to chemotherapy and reaching operability after primarily inoperable gastric cancer

Meeting Abstract

  • corresponding author presenting/speaker Jörg Fahlke - Chirurgische Klinik, Universitätsklinikum Magdeburg, Deutschland
  • Cornelia Schmidt - Chirurgische Klinik, Universitätsklinikum Magdeburg
  • Patrick Stübs - Chirurgische Klinik, Universitätsklinikum Magdeburg
  • Arndt Hribaschek - Chirurgische Klinik, Universitätsklinikum Magdeburg
  • Silke Schmidt - Chirurgische Klinik, Universitätsklinikum Magdeburg
  • Kathrin Zierau - Chirurgische Klinik, Universitätsklinikum Magdeburg
  • Hans-Ulrich Schulz - Chirurgische Klinik, Universitätsklinikum Magdeburg
  • Hans Lippert - Chirurgische Klinik, Universitätsklinikum Magdeburg

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO197

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Fahlke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Concepts of multimodal therapy have gained increasing significance in treatment of patients with gastric carcinoma in recent years. A permanent cure can only be accomplished through R0 tumor resection. After responding to chemotherapy there may be a chance of reaching operability after primarily inoperable diagnostic findings. In surgery following chemotherapy the extent of resection depends on the current size of the tumor with the question being, whether or not patients will profit from a surgical intervention in a long term perspective.

Patients and method: Between 01 Dec 1996 and 01 June 2004, 392 patients with gastric carcinoma have been admitted for surgical therapy at the Surgical Clinic of the Otto-von-Guericke University. Diagnostics showed locally progressed inoperable tumor growth in 49 patients of this group. Inoperability was determined in an interdisciplinary tumor board. After initiating systemic chemotherapy 28 of these patients showed operability in re-staging and underwent surgery. Radiological diagnostics showed complete remission in 3 of these 28 patients. The median age at the time of surgery was 59 years (31-78 years). 18 patients were male, 10 patients were female. All patients underwent gastrectomy with reconstruction in Y-Roux technique and D2 lymphadenectomy. While an R0-condition could be reached in 20 patients, the resection had to be classified as R1 in 8 patients due to pathological findings in the circumferential transection. Patients with an R0-resection did not receive further postoperative treatment, while preoperatively started chemotherapy was continued in patients with an R1-resection.

Results: The current median time of monitoring is 15.5 months (1-100). In 16 patients a relapse has been diagnosed during postoperative monitoring. Median survival time from the point of first diagnosis is currently 22.5 months. Median survival time after surgery is currently 18 months. The survival rates after 1, 3, and 5 years are 68, 21, and 18 percent. As of today 5 patients have not encountered a relapse after 5 years. These figures conclude that patients responding to chemotherapy after initially inoperable gastric carcinoma profit from surgical resection, emphasizing the significance of concepts of multimodal therapy in treatment of patients with progressed gastric carcinoma.