comparing efficacy of preoperative neo-adjuvant chemotherapy and surgery versus surgery alone in patients with resectable gastroesophageal cancer.

background: recent researches have led to find strategies to prevent relapse and to improve survival for gastric cancer patients, including preoperative neo-adjuvant approaches. however, the efficacy of some neo-adjuvant regimens including 5-fluorouracil, cisplatin, and docetaxel have been less investigated. the present study evaluated the outcome and mid-term survival of patients with gastric cancer who undergoing this regimen. methods: in a randomized double-blinded controlled trial performed at the firoozgar hospital in tehran in 2011-12, 61 patients were randomly assigned to treatment (32 to neo-adjuvant chemotherapy with docetaxel, cisplatin and 5-fluorouracil (5-fu) before surgery and 27 to surgery alone). the present study tried to assess the efficacy of neoadjuvant chemotherapy regarding improvement of mid-term survival, complications, and r0 resection status. results: the two groups were matched in terms of gender, mean age, cancer location, and tnm staging. however, r0 resection in the former group was 85.7%; while this indicator in the isolated surgery group was significantly lower (61.5%). regarding who performance, no significant difference was observed across the two groups. patients in neo-adjuvant chemotherapy group were followed for mean follow-up time 10.32 months and those who categorized in isolated surgery group were followed for mean follow-up time 10.88 months. mid-term mortality rate in the two groups was 14.3% and 15.4%, respectively (p = 0.866). in this regard, 3-, 6-, and 9-month survival rate in neo-adjuvant chemotherapy group was 96.4%, 89.3%, and 85.7%, respectively. these survival rates in the surgery group were 92.3%, 88.5%, and 84.6%, respectively. multivariable logistic regression analysis showed that among all study variables, only r0 resection status could predict mid-term mortality. conclusion: neo-adjuvant chemotherapy and surgery compare to surgery alone more improve r0 resection status, but mid-term survival rate is similar in the two regiments. r0 resection status can effectively predict appropriate mid-term survival in undertreated patients.