This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Impact of perioperative chemotherapy on oncological outcomes after gastric cancer surgery. BJS 2014; 101: 1712-1720.
Published: 13th October 2014
Authors: E. A. Bringeland, H. H. Wasmuth, R. Fougner, P. Mjønes, J. E. Grønbech
Background
Perioperative chemotherapy has become standard care for resectable gastric cancer. However, available evidence is based on a limited number of trials, and the outcomes in routine clinical practice and in unselected patients are scarcely reported.
Method
The study included a consecutive series of patients with resectable gastric cancer treated between 2001 and 2011 in Central Norway. Before 2007, patients with resectable gastric cancer did not receive perioperative chemotherapy. Since 2007, medically fit patients with resectable gastric cancer and aged 75 years or less have been offered this. Response rates were evaluated by
Results
About two‐thirds (259) of the 419 patients registered were aged 75 years or less at diagnosis. Ninety‐five of 136 patients in the later interval were eligible for chemotherapy, of whom 90 actually received the specified regimen, and 78 (87 per cent) were able to complete the preoperative course. Only 40 (44 per cent) completed all scheduled preoperative and postoperative cycles. Thirty‐eight (43 per cent) of 89 evaluable patients showed a definite response on
Conclusion
Perioperative chemotherapy was completed in less than half of the patients with resectable gastric cancer. An observed tumour response to chemotherapy did not translate into any long‐term survival benefit compared with surgery alone.
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