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Original article: role of adjuvant chemotherapy in a perioperative chemotherapy regimen for gastric cancer

Authors :
Lichthardt, Sven
Kerscher, Alexander
Dietz, Ulrich A.
Jurowich, Christian
Kunzmann, Volker
von Rahden, Burkhard H. A.
Germer, Christoph-Thomas
Wiegering, Armin
Source :
BMC Cancer
Publication Year :
2016

Abstract

Background Multimodal treatment strategies – perioperative chemotherapy (CTx) and radical surgery – are currently accepted as treatment standard for locally advanced gastric cancer. However, the role of adjuvant postoperative CTx (postCTx) in addition to neoadjuvant preoperative CTx (preCTx) in this setting remains controversial. Methods Between 4/2006 and 12/2013, 116 patients with locally advanced gastric cancer were treated with preCTx. 72 patients (62 %), in whom complete tumor resection (R0, subtotal/total gastrectomy with D2-lymphadenectomy) was achieved, were divided into two groups, one of which receiving adjuvant therapy (n = 52) and one without (n = 20). These groups were analyzed with regard to survival and exclusion criteria for adjuvant therapy. Results Postoperative complications, as well as their severity grade, did not correlate with fewer postCTx cycles administered (p = n.s.). Long-term survival was shorter in patients receiving postCTx in comparison to patients without postCTx, but did not show statistical significance. In per protocol analysis by excluding two patients with perioperative death, a shorter 3-year survival rate was observed in patients receiving postCTx compared to patients without postCTx (3-year survival: 71.2 % postCTx group vs. 90.0 % non-postCTx group; p = 0.038). Conclusion These results appear contradicting to the anticipated outcome. While speculative, they question the value of post-CTx. Prospectively randomized studies are needed to elucidate the role of postCTx.

Details

Language :
English
Database :
OpenAIRE
Journal :
BMC Cancer
Accession number :
edsair.pmid.dedup....cc68a77a99d2745fed81cbb9652df26a