Endoscopic response evaluation of gastric primary lesion for chemotherapy compared to CT in advanced gastric cancer.

Abstract

50 Background: Significance of evaluation of gastric primary lesion with endoscopy remains unclear in chemotherapy (CTx) for advanced gastric cancer (AGC). Endoscopic evaluation is not necessary in RECIST. Methods: We compare the response of chemotherapy using RECIST by CT with or without upper GI endoscopy in AGC cases retrospectively. Among 175 cases of unresectable AGC treated by CTx in our institution between 2004 and 2008, we reviewed 141 evaluations in 74 cases which were examined by both endoscopy and CT within 2 weeks before and after CTx. Results: Patient backgrounds: Gender; M47/F27, Age; median 59(24-75), PS; 0or1=71/2=3, histological type; intestinal28/diffuse46, metastatic site; LN47/liver26/peritoneum29, CT per case; median number 4.5/ median interval 64.5days, endoscopy per case; median number 2/ median interval 91.3days. Response evaluation for gastric primary lesion between CT and endoscopy was compared in 141 examinations. Identical response 123(87.2%); both non-CR/non-PD 101/ both PD 22, not identical response 10(7.1%); endoscopy PD /CT non-CR/non-PD 10, not detected by CT; 8(5.7%). All of the cases of not identical response between CT and endoscopy were PD in endoscopy whereas non-CR/non-PD in CT. The overall response evaluation with or without endoscopy was concord in 133 evaluations (94.3%). Conclusions: It is almost appropriate that response evaluation of chemotherapy in AGC is mainly performed by CT without endoscopy to primary gastric lesion.