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Introduction Since 2006, the results of MAGIC trial demonstrated that a perioperative regimen of Epirrubicin-cisplatin-5FU (ECF) decreases tumour size and stage, with significantly improvement in overall survival (OS) and progression-free survival (PFS). However, the survival rate of patients (pts) with locally advanced resectable gastric cancer (LARGC) remains poor. Our aim was to identify prognostic factors and their correlation with a more aggressive disease in our area. Methods We retrospectively reviewed 65 pts with LARGC who were planned to receive perioperative chemotherapy followed by surgery at our institution, between May 2008 and February 2012. We analysed the correlation between mOS and recurrence free survival (RFS) with patient characteristics, sex and age, and some tumour characteristics, as histology, tumour localization, both clinical and pathological stage, and tumour regression rate (TRR). OS and RFS was analysed using Kaplan-Meier curves and the differences with Log-Rank test. Results 16 women and 49 men were analysed, with a median age of 63 years (range 38-78). 41% pts had a diffuse type, 49% an intestinal type and 10% a mixt type adenocarcinoma. 30% of tumours were proximal and 70% were distal. There were clinically 1.6% stage I, 49.2% stage II and 49.2% stage III pts. 58 pts (98%) completed 3 cycles of neoadjuvant chemotherapy. 42 pts received ECF, whereas 23 pts received other schemes (13 pts carboplatin+5FU, 8 pts cisplatin+5FU, 2 pts other combinations). Radiological downstaging was observed in 59% pts. 40 total gastrectomy, 14 partial gastrectomy and 9 Ivor-Lewis were conducted. There was 1 pt who underwent a palliative derivation. We found 1 surgery-related death. Adjuvant chemotherapy was delivered in 45 pts. There were pathologically 22% stage I, 47% stage II, 22% stage III and 9% stage IV pts. Pathological downstaging in terms of TRR (RG1+RG2+RG3) was obtained in 42% pts, achieving 3 complete responses (RG1). 4 pts had marked regression (RG2) and 19 pts had 10-50% viable tumour remaining (RG3), meanwhile 36 pts did not respond (RG4). The median follow-up of the whole group was 24 months. We did not reach nor the mOS neither the mRFS, given that 70% pts were alive after 2 years. 2 year OS was 72% (95 CI, 60.3%-83.6%) and 2 year RFS was 52.5% (95 CI, 39.8%-65.3%). Age Conclusion Preoperative chemotherapy contributes to pathological downstaging and histologic tumour regression in less than 50% pts. Age>60 years, minor pathological downstaging and tumour regression rate have been objectively correlated to poor outcomes. New patient and tumour characteristics must be identified as prognostic and predictive factors. The development of targeted therapies should provide new possibilities in the treatment of LARGC.

Introduction The long term survival of patients with resectable pancreatic cancer (PC) is appalling, so data regarding what factors may influence outcome, following attempted curative resection is essential in order to optimize the treatment options for patients. Our aims were to analyze prognostic factors influencing survival in patients with resected PC in our institution. Methods Eligible participants included all persons diagnosed with pancreatic cancer from June 2004 to August 2008 that underwent pancreaticoduodenectomy for adenocarcinoma of only pancreatic head at the Surgical Department in Bellvitge Hospital. Risk factors associated with overall survival (OS) and Progression Free Survival (PFS) were assessed with the Kaplan-Meier survival method and the log-rank test. Demographic, tumour, and clinical variables were assessed using the Cox proportional hazards model. We also examined plasmatic VEGF (pVEGF) levels in these patients to evaluate the prognostic significance of these levels and correlate the results with the clinic- pathological features, microvascular density and K-RAS gene status. Results The median follow-up was 17.8 months for all patients. The median follow-up for living patients was 40 months (range 3-83 months). The median survival time for all patients was 21.26 months (95% confidence interval 13.29-29.24 months).The median Progression Free Survival for all patients was 15.76 months (95% confidence interval 4.99-26.54 months). Pathological stage was unfavorable prognostic factor in our pancreas cancer patients by univariate and multivariate analysis for OS and PFS. Perineural and vascular invasion as well as R1 resection were also negative prognostic factors for PFS. There was no survival correlation between high levels of p-VEGF and the remaining clinico-pathological features (including the number of resected nodes, microvascular density or K-RAS gene status). Conclusion Our results are consistent with the most important published studies and tumor characteristics remain the best significant features influencing survival after pancreatic cancer surgery.

Introduction Fluoropyrimidine (F) and platinum (P) combination chemotherapy has been widely used as a first-line treatment of advanced gastric cancer (AGC). Docetaxel has been considerable promise against this disease. We want to investigate the efficacy and safety of docetaxel monotherapy as salvage chemotherapy for AGC in clinical practice and determine the prognostic factors in these patients. Methods We retrospectively reviewed the medical records of patients with AGC for whom fluoropyrimidine and platinum had previously failed and who had received docetaxel salvage monotherapy between March 2005 and December 2011. Docetaxel was administered at a dose of 75 mg/m(2) intravenously every 3 weeks with dexamethasone prophylaxis. Results A total of 40 patients received 133 cycles of docetaxel with a median of three cycles per patient (range 1-6). The median age was 63 years (range 38-78 years). The objective response rate was 10%, with 4 partial responses, with response duration of 1.1, 2.2, 2.6 and 7.1 months respectively. An additional 4 patients achieved stable disease. The median time to progression (TTP) for all patients was 1.9 months [95% confidence interval (CI), 1.2-2.7] and the median overall survival (OS) from the start of docetaxel chemotherapy was 4.1 months (95% CI, 3.6-4.6). Grade 3/4 neutropenia and febrile neutropenia occurred in 15% of patients and anemia occurred in 12.5%. The incidence of non-hematologic toxicities of grade 3 or worse was asthenia 25%, anorexia 12.5%, diarrhea 2.5% and stomatitis 2.5%. Multivariate analysis showed that the Eastern Cooperative Oncology Group (ECOG) performance status (0 or 1 versus 2) was an independent prognostic factor for both TTP and OS. Number of metastatic sites was a predictor for better TTP. Conclusion Docetaxel 75 mg/m(2) is relatively active against AGC as a second-line salvage treatment after failure of fluoropyrimidine and platinum combination chemotherapy in general clinical practice. The toxicity profile is moderate. Further investigation in salvage therapy is needed, in order to improve survival and provide palliation of symptoms.