1. The Impact of Perioperative Chemotherapy on Survival in Patients With Gastric Signet Ring Cell Adenocarcinoma
- Author
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Mathieu Messager, Jérémie H. Lefevre, Virginie Pichot-Delahaye, Amine Souadka, Guillaume Piessen, Christophe Mariette, Jean Pierre Arnaud, Jean Michel Balon, Frank Bonnetain, Frédéric Borie, Dorothée Brachet, Cécile Brigand, Nicolas Carrere, Xavier Benoit D'Journo, Pierre Dechelotte, Jean Robert Delpero, Abdenaceur Dhari, Sylvain Fabre, Manuel Fernandez, Renaud Flamein, Brigitte Gillet, Aude Glaise, Olivier Glehen, Diane Goéré, Marie Guilbert, Jérôme Guiramand, Mohamed Hebbar, Noël Huten, Kevin Kraft, Emmanuelle Leteurtre, Damien Louis, Jean Yves Mabrut, Benjamin Mathieu, Bernard Meunier, Sophie Michalak, Francis Michot, Bertrand Millat, François Paye, Frédérique Peschaud, Denis Pezet, Marc Pocard, Ariane Poisson, Michel Prudhomme, Jean Marc Regimbeau, Timothée Thiébot, Pascal-Alexandre Thomas, Basile Tsilividis, and Florence Vandois
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Gastroenterology ,Perioperative Care ,Stomach Neoplasms ,Internal medicine ,medicine ,Carcinoma ,Humans ,Stage (cooking) ,Retrospective Studies ,Chemotherapy ,Signet ring cell ,business.industry ,Standard treatment ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Intention to Treat Analysis ,Surgery ,Regimen ,Treatment Outcome ,Chemotherapy, Adjuvant ,Multivariate Analysis ,Adenocarcinoma ,Female ,business ,Carcinoma, Signet Ring Cell ,hormones, hormone substitutes, and hormone antagonists - Abstract
The aim of this retrospective study was to evaluate the survival impact of perioperative chemotherapy (PCT) in patients with gastric signet ring cell (SRC) adenocarcinoma.PCT is a standard treatment for advanced resectable gastric adenocarcinoma (GA). SRC has a worse prognosis compared to non-SRC and the chemosensitivity of SRC is uncertain.Among 3010 patients registered in 19 French centers between January 1997 and January 2010, 1050 (34.9%) were diagnosed with SRC. Of those treated with curative intent (n = 924), 171 (18.5%) received PCT with surgery (PCT group), whereas 753 (81.5%) were treated with primary surgery (S group). PCT was based mainly on a fluorouracil-platinum doublet or triplet regimen.The groups were comparable regarding age, gender, American Society of Anesthesiologists (ASA) score, malnutrition, tumor location and cTNM stage. 60 patients did not undergo resection because of tumor progression (10) or metastases (50) found at operation. The R0 resection rates were 65.9% and 62.3% in the S and PCT groups, respectively (P = 0.308). Fewer patients received adjuvant chemotherapy in the S group than in the PCT group (35.2% vs. 66.5%, P0.001). At a median follow-up of 31.5 months, the median survival was shorter in the PCT group (12.8 vs. 14.0 months, P = 0.043). On multivariate analysis, PCT was found to be an independent predictor of poor survival (HR = 1.4, 95% CI 1.1-1.9, P = 0.042).PCT provides no survival benefit in patients with gastric SRC. Clinical Trial.gov record: ADCI001, Clinical Trial.gov identifier NCT01249859.
- Published
- 2011
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