704 Role of Preoperative Staging in Patients With Small Intestinal Neuroendocrine Tumors

Abstract

the PERIOP group to receive: (1) at least one cycle of chemotherapy (56% vs 100%, p<0.001); (2) all recommended systemic therapy (44% vs 69%, p=0.002); (3) adjuvant XRT (44% vs 61%, p=0.09); and (4) all recommended systemic and XRT combined (37% vs 57%, p=0.015). Forty-one (44%) patients in the SURG group did not receive any adjuvant chemotherapy due to surgical complications (n=19, 46%), patient refusal (n=13, 32%), or disease progression (n=9, 22%). Of the 48 ASA class III patients who had surgery first, only 22 (46%) received any adjuvant CTX, whereas 22 of the 26 (85%) ASA class III patients in the PERIOP group received all of the recommended pre-op CTX, and 58% received all of the recommended pre-op and post-op CTX. Conclusions: Fewer than 40% of patients with adenocarcinoma of the stomach who undergo a surgery-first approach receive all recommended adjuvant CTX and XRT, as opposed to nearly 60% of patients treated with perioperative CTX, including patients of poorer performance status. Neoadjuvant therapy should be strongly considered for all patients with locoregionally advanced adenocarcinomas of the stomach.