Metastatic Lymph Node Targeted Chemosensitivity Test for Gastric Cancer

• Published in: The Journal of surgical research 2011-12, Vol.171 (2), p.657-662
• Main Authors: Jang, You-Jin, M.D., Ph.D, Kim, Jong-Han, M.D., Ph.D, Park, Sung-Soo, M.D., Ph.D, Park, Seong-Heum, M.D., Ph.D, Kim, Seung-Joo, M.D., Ph.D, Kim, Chong-Suk, M.D., Ph.D, Mok, Young-Jae, M.D., Ph.D
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adenocarcinoma, Mucinous - drug therapy; Adenocarcinoma, Mucinous - secondary; Adenocarcinoma, Mucinous - surgery; Adenosine Triphosphate - pharmacology; Adult; Aged; Aged, 80 and over; Antibiotics, Antineoplastic - pharmacology; Antimetabolites, Antineoplastic - pharmacology; Biological and medical sciences; Carcinoma, Signet Ring Cell - drug therapy; Carcinoma, Signet Ring Cell - secondary; Carcinoma, Signet Ring Cell - surgery; chemosensitivity test; Chemotherapy, Adjuvant - methods; Cisplatin - pharmacology; Doxorubicin - pharmacology; Female; Fluorouracil - pharmacology; gastric cancer; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; In Vitro Techniques; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Organoplatinum Compounds - pharmacology; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; tumor heterogeneity; Tumors
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2010.07.003

Background The objective of this study was to compare the chemosensitivity of primary tumor and metastasized lymph node from patient with gastric adenocarcinoma. Materials and Methods We studied 26 gastric cancer patients with lymph node metastasis who underwent gastric resection at the Korea University Guro Hospital from Feb 2007 to July 2008. The chemosensitivity of primary tumor and metastatic lymph node were studied using an adenosine triphosphate-based chemotherapy response assay (ATP-CRA). Results The concordance rate of the ATP-CRA test was 30.8% (8/26). The concordance rate between primary tumor and metastatic N2 group lymph node was only 9.1% (1/11). The metastatic tumor inhibition rates with 5-fluorouracil, cisplatin, doxorubicin, and oxaliplatin were higher than the inhibition rates for primary tumor. Tumor inhibition rates was significantly different between primary tumor and metastatic tumor after doxorubicin treatment (27.734 ± 20.95 versus 38.403 ± 26.87, P = 0.021). We detected simple correlations of tumor inhibition rates between primary and metastatic tumors with cisplatin ( r  = 0.661, P < 0.001) and doxorubicin ( r = 0.475, P  = 0.031). Conclusions We observed differences between first choice chemotherapeutic agents based on ATPCRA tests of primary tumor and metastatic tumor in lymph node. Therefore, chemotherapeutic agents should be carefully selected for adjuvant chemotherapy using a chemosensitivity test.