Association between hypoxia level in gastric cancer, assessed by 31P NMR spectroscopy, and results of patients treatment with different methods

Abstract

Aim: to analyse the association between gastric cancer hypoxia level and results of patients treatment. Patients and methods: the specimens of primary gastric cancer were investigated. 150 naïve patients were enrolled into the study. Tumor hypoxia level was assessed by 31P NMR spectroscopy in perchloric extracts of tumor obtained after surgical excision. Patients were treated by operation alone, neoadjuvant or adjuvant chemotherapy in accordance with standards of therapy. Results: it was determined that hypoxia of primary tumor decreases the efficacy of neoadjuvant as well as adjuvant chemotherapy. It was revealed that negative influence of regional lymph node metastases on the disease outcome is enhanced by tumor hypoxia. It was shown that the risk of unfavorable disease outcome in patients with N0 category and tumor characterized by severe hypoxia is significantly increased. Conclusions: negative influence of tumor hypoxia on neoplasia response to cytostatic chemotherapy was confirmed; the evidences for the expediency of the evaluation of hypoxia level in gastric cancer in biopsy and/or operation specimens before the choice of therapy methods were obtained.