Prospective Study
Copyright ©The Author(s) 2021.
World J Gastrointest Oncol. Oct 15, 2021; 13(10): 1532-1543
Published online Oct 15, 2021. doi: 10.4251/wjgo.v13.i10.1532
Table 1 Clinical target volume for elective nodal regions according to the Japanese Gastric Cancer Association guidelines
Tumor location
CTV for elective nodal regions
Upper 1/3rd or gastroesophageal junction110, 1-3, 7, 9-11
Middle 1/3rd1-3, 5-13, 141, 16a
Lower 1/3rd3, 5-9, 11p, 12-13, 141, 16a
Table 2 Patient characteristics
Characteristic
n
%
Age in yr, median (range)53 (24-71)
Men2870.0
Tumor size in cm, median (range)5.0 (2-20)
Location of primary tumor
Upper 1/3rd of stomach820
Middle 1/3rd of stomach820
Lower 1/3rd of stomach1435
≥ 2 sites involved1025
Surgery type
Partial gastrectomy3690
Total gastrectomy410
Positive LNs, median (range)7 (1-26)
LNs resected, median (range)24 (15-56)
LN ratio, median (range)0.27 (0-0.86)
Extent of dissection
D11845
D22255
Lauren type
Intestinal type1230
Diffuse type1640
Mixed type1230
Tumor differentiation
Good12.5
Moderate820
Poor3177.5
Lymphatic/vascular invasion
Absent1640
Present2460
Perineural invasion
Absent3075
Present1025
Signet ring cells
Absent2972.5
Present1127.5
Tumor deposit
Absent3485
Present615
Stage (AJCC 7th)
IIa25
IIb615
IIIa1127.5
IIIb1127.5
IIIc1025
Stage (AJCC 6th)
Ib25
II1435
IIIa1025
IIIb25
IV1230
Table 3 Overall toxicities at the recommended dose, n = 40
Toxicity
Grade 1-2, n (%)
Grade 3-4, n (%)
Nausea22 (45)3 (7.5)
Vomiting15 (37.5)4 (10)
Anorexia27 (67.5)2 (5)
Esophagitis6 (15)3 (7.5)
Diarrhea5 (12.5)0
Abdominal pain1 (2.5)1 (2.5)
Gastritis9 (22.5)2 (5)
Fatigue21 (52.5)1 (2.5)
Weight loss8 (20)0
HFS14 (35)0
Leukopenia27 (67.5)5 (12.5)
Neutropenia7 (17.5)1 (2.5)
Anemia3 (7.5)0
Thrombocytopenia17 (42.5)3 (7.5)
ALT/AST2 (5)0
Table 4 Survival outcomes
Time
DFS (95%CI)
OS (95%CI)
LRFS (95%CI)
DMFS (95%CI)
3 yr66.2 (58.6-73.8)75 (68.2-81.8)80.8 (74.2-88.6)72.4 (64.9-79.9)
5 yr55.2 (47.1-63.3)58.9 (51.0-66.8)80.8 (74.2-88.6)60.4 (52.1-68.7)
7 yr152.3 (44.1-60.5)48.2 (39.5-56.9)80.8 (74.2-88.6)57.2 (48.8-65.6)