Abstract | BACKGROUND:
Adjuvant chemoradiotherapy improved survival in patients with resected gastric adenocarcinoma in the Southwest Oncology Group/Intergroup 0116 trial. Our objective was to examine the impact of adjuvant treatment on overall survival (OS) in the general population. METHODS: Patients 18-85 years old who had undergone resection of non-metastatic gastric adenocarcinoma between May 2000 and December 2003, were identified from the Surveillance Epidemiology and End Results (SEER) database. Patients who had received pre-operative irradiation, had unknown stage or radiation status, or had a survival of 3 months or less from the date of diagnosis were excluded. Survival of those who received post-operative irradiation was compared with those who did not; Kaplan-Meier methods and Cox proportional hazards models were used. RESULTS: Of 4,041 patients, there was improved survival for those receiving adjuvant irradiation for stages III and IVM0, with a median OS of 31 versus 24 months (P = 0.005) and 20 versus 15 months (P < 0.001), respectively, and a trend for improved survival in univariate analysis of stage II (P = 0.0535). In final adjusted analysis, adjuvant irradiation significantly improved OS in stages III (HR: 0.71, P = 0.0007) and IVM0 (HR: 0.66, P < 0.0001). Adjusted analysis using a propensity score suggested that the benefit of adjuvant irradiation was similar in stage-II and -III patients. However, there was no statistical improvement in survival for stage-Ib and -II patients who had received adjuvant irradiation. CONCLUSIONS: In this population-based analysis, adjuvant radiotherapy for stage-III and IVM0 gastric cancer significantly improved OS. Analysis of stage-Ib and -II patients is limited by small numbers, but there may not be the same benefit.
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Authors | Natalie G Coburn, Anand Govindarajan, Calvin H L Law, Ulrich Guller, Alex Kiss, Jolie Ringash, Carol J Swallow, Nancy N Baxter |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 15
Issue 2
Pg. 500-7
(Feb 2008)
ISSN: 1534-4681 [Electronic] United States |
PMID | 18026800
(Publication Type: Journal Article)
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Topics |
- Adenocarcinoma
(mortality, pathology, radiotherapy, surgery)
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Female
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Proportional Hazards Models
- Radiotherapy, Adjuvant
- SEER Program
- Stomach Neoplasms
(mortality, pathology, radiotherapy, surgery)
- Survival Analysis
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