Combination Chemotherapy and Surgery in Treating Patients With Locally Advanced Stomach Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed locally advanced gastric carcinoma that is considered operable

  • T3-4, Nx, M0 OR
  • Tx, N+, M0

• Lymph nodes considered positive by sonography should be at least 2 of the following:

  • Round
  • Echopoor
  • Sharp borders
  • At least 0.5 cm

• No distant metastases, including peritoneal carcinomatosis

  • CT scan and peritoneal lavage mandatory

PATIENT CHARACTERISTICS:

Age:

• 18 to 75

Performance status:

• 0-2

Life expectancy:

• Greater than 12 weeks

Hematopoietic:

• WBC at least 4,000/mm^3
• Platelet count at least 100,000/mm^3

Hepatic:

• Bilirubin normal
• AST or ALT no greater than 1.5 times upper limit of normal (ULN)
• Alkaline phosphatase no greater than 2.5 times ULN

Renal:

• Adequate renal function within limits to allow for treatment with cisplatin

Cardiovascular:

• No unstable cardiac disease requiring treatment
• No congestive heart failure or angina pectoris even if medically controlled
• No significant arrhythmias
• No myocardial infarction within past 6 months
• Ejection fraction greater than 50% on cardiac sonography or MUGA scan

Other:

• Not pregnant or nursing
• Fertile patients must use effective contraception
• No other prior malignancy except basal cell carcinoma of the skin or adequately treated carcinoma in situ of the cervix
• No grade 2 or greater peripheral neuropathy of any origin (e.g., alcohol, diabetic)
• No history of anaphylaxis
• No other serious concurrent illness or medical condition that would preclude study therapy
• No history of significant neurologic or psychiatric disorders (e.g., psychotic disorders, dementia, or seizures)

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No concurrent biologic therapy for gastric carcinoma

Chemotherapy:

• No other concurrent chemotherapy for gastric carcinoma

Endocrine therapy:

• No concurrent endocrine therapy for gastric carcinoma

Radiotherapy:

• No concurrent radiotherapy for gastric carcinoma

Surgery:

• See Disease Characteristics

Other:

• At least 30 days since prior treatment in a clinical trial
• No other concurrent experimental drugs
• No other concurrent anticancer therapy