Timing of chemotherapy and survival in patients with resectable gastric adenocarcinoma
作者机构：Division of Surgical Oncology City of Hope Comprehensive Cancer Center Department of Biostatistics City of Hope Comprehensive Cancer Center Department of Surgery University of Southern California Department of Surgery Harbor-UCLA Medical Center Division of Colorectal Surgery Memorial Sloan-Kettering Cancer Center
出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)
年 卷 期：2013年第5卷第12期
页 面：321-328页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
基 金：NCI NIH HHS [P30 CA033572] Funding Source: Medline
主 题：Chemotherapy Gastric cancer Adjunct therapy Postoperative therapy Preoperative therapy Timing
摘 要：AIM: To evaluate the timing of chemotherapy in gastric cancer by comparing survival outcomes in treatment groups. METHODS: Patients with surgically resected gastric adenocarcinoma from 1988 to 2006 were identified from the Los Angeles County Cancer Surveillance Program. To evaluate the population most likely to receive and/or benefit from adjunct chemotherapy, inclusion criteria consisted of Stage Ⅱ or Ⅲ gastric cancer patients 18 years of age who underwent curative-intentsurgical resection. Patients were categorized into three groups according to the receipt of chemotherapy:(1) no chemotherapy;(2) preoperative chemotherapy; or(3) postoperative chemotherapy. Clinical and pathologic characteristics were compared across the different treatment ***: Of 1518 patients with surgically resected gastric cancer, 327(21.5%) received perioperative chemotherapy. The majority of these 327 patients were male(68%) with a mean age of 61.5 years; and they were significantly younger than non-chemotherapy patients(mean age, 70.7; P 0.001). Most patients had tumors frequently located in the distal stomach(34.5%). Preoperative chemotherapy was administered to 11.3% of patients(n = 37) and postoperative therapy to 88.7% of patients(n = 290). An overall survival benefit according to timing of chemotherapy was not observed on univariate or multivariate analysis. Similar results were observed with stagespecific survival analyses(5-year overall survival: Stage Ⅱ, 25% vs 30%, respectively; Stage Ⅲ, 14% vs 11%, respectively). Therefore, our results do not identify a survival advantage for specific timing of chemotherapy in locally advanced gastric cancer. CONCLUSION: This study supports the implementation of a randomized trial comparing the timing of perioperative therapy in patients with locally advanced gastric cancer.
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