Adjuvant Therapy Completion Rates in Patients with Gastric Cancer Undergoing Perioperative Chemotherapy Versus a Surgery-First Approach.

Abstract

Delayed recovery after gastrectomy may preclude the administration of adjuvant therapy in a significant percentage of patients who undergo elective gastrectomy as the initial therapy for gastric cancer. Clinicopathologic and treatment variables of 155 patients undergoing potentially curative gastrectomy for stages Ib-IIIc gastric adenocarcinoma from 2001 to 2014 were analyzed, and rates of receipt of chemotherapy and radiotherapy in patients treated with either a surgery-first approach (SURG) or neoadjuvant therapy followed by surgery followed by postoperative therapy (PERIOP) were compared. SURG patients (n = 93) were older and more likely to have distal tumors and to undergo distal gastrectomy and D1 lymphadenectomy than PERIOP patients (n = 62). The distribution of ASA scores was similar between groups. SURG patients were less likely than PERIOP patients to complete at least one cycle of chemotherapy (56 vs 100%, P = 0.001) and all recommended chemotherapy and radiation therapy (44 vs 66%, P = 0.013). These findings were consistent for SURG patients treated during different time periods throughout the study and for patients of poorer performance status. A significantly higher percentage of gastric cancer patients treated with perioperative chemotherapy receive some or all of the recommended components of multimodality therapy than patients treated with a surgery-first approach.

• Authors: Eva Fuentes, Rima Ahmad, Theodore S Hong, Jeffrey W Clark, Eunice L Kwak, David W Rattner, John T Mullen
• Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) Vol. 20 Issue 1 Pg. 172-9; discussion 179 (Jan 2016) ISSN: 1873-4626 [Electronic] United States
• PMID: 26394879 (Publication Type: Journal Article)

Topics

• Adenocarcinoma (surgery, therapy)
• Aged
• Chemotherapy, Adjuvant
• Female
• Gastrectomy
• Humans
• Lymph Node Excision
• Male
• Middle Aged
• Neoadjuvant Therapy
• Radiotherapy, Adjuvant
• Retrospective Studies
• Stomach Neoplasms (surgery, therapy)