Does neoadjuvant chemotherapy improve outcomes for patients with gastric cancer?

Subhasis Misra, Felipe E. Pedroso, Peter J. Dipasco, Naveenraj L. Solomon, Elisabeth Gennis, Dido Franceschi, Bach Ardalan, Leonidas Koniaris

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The role of neoadjuvant and adjuvant therapy for gastric cancer remains undefined. We compared the outcomes for patients treated with surgery alone or with the addition of adjuvant or neaodjuvant treatment. Methods: A single-institution, retrospective evaluation of a prospective database of gastric cancer patients treated from 2000 to 2008 was performed. Results: Overall, 173 patients with gastric cancer underwent surgical extirpation. Of the 173 patients, 43% had early-stage disease (less than stage 2) and 57% had late-stage disease (stage 2 or greater; American Joint Committee on Cancer, 2010). The median survival from the date of diagnosis for those treated with neoadjuvant chemotherapy (NAC) (n = 35), adjuvant chemotherapy (n = 21), adjuvant chemoradiotherapy (n = 18), both NAC and adjuvant chemotherapy (n = 11), or surgery alone (n = 88) was 26.3, 17.3, greater than 60, greater than 60, and 50.3 months, respectively. The addition of NAC to surgery was detrimental to survival in those with early-stage disease (P = 0.002) and did not improve survival in those with late-stage disease (P = 0.687). For those with late-stage disease, surgery with adjuvant chemoradiotherapy exhibited the best overall survival compared with surgery alone (P = 0.021) or surgery with adjuvant chemotherapy (P = 0.01). Patients treated with NAC had a greater rate of R0 resection compared with surgery alone (P = 0.049). Conclusions: NAC for patients with gastric cancer does not significantly improve the overall outcomes for those with late-stage disease and could be detrimental to survival for those with early-stage disease. However, treatment with NAC resulted in an improved rate of R0 resection.

Original languageEnglish (US)
Pages (from-to)623-631
Number of pages9
JournalJournal of Surgical Research
Volume178
Issue number2
DOIs
StatePublished - Dec 2012
Externally publishedYes

Fingerprint

Stomach Neoplasms
Drug Therapy
Adjuvant Chemotherapy
Adjuvant Chemoradiotherapy
Survival
Neoadjuvant Therapy
Databases
Neoplasms

Keywords

  • Adenocarcinoma
  • Oncology
  • Stomach
  • Survival
  • Therapy

ASJC Scopus subject areas

  • Surgery

Cite this

Misra, S., Pedroso, F. E., Dipasco, P. J., Solomon, N. L., Gennis, E., Franceschi, D., ... Koniaris, L. (2012). Does neoadjuvant chemotherapy improve outcomes for patients with gastric cancer? Journal of Surgical Research, 178(2), 623-631. https://doi.org/10.1016/j.jss.2012.04.062

Does neoadjuvant chemotherapy improve outcomes for patients with gastric cancer? / Misra, Subhasis; Pedroso, Felipe E.; Dipasco, Peter J.; Solomon, Naveenraj L.; Gennis, Elisabeth; Franceschi, Dido; Ardalan, Bach; Koniaris, Leonidas.

In: Journal of Surgical Research, Vol. 178, No. 2, 12.2012, p. 623-631.

Research output: Contribution to journalArticle

Misra, S, Pedroso, FE, Dipasco, PJ, Solomon, NL, Gennis, E, Franceschi, D, Ardalan, B & Koniaris, L 2012, 'Does neoadjuvant chemotherapy improve outcomes for patients with gastric cancer?', Journal of Surgical Research, vol. 178, no. 2, pp. 623-631. https://doi.org/10.1016/j.jss.2012.04.062
Misra S, Pedroso FE, Dipasco PJ, Solomon NL, Gennis E, Franceschi D et al. Does neoadjuvant chemotherapy improve outcomes for patients with gastric cancer? Journal of Surgical Research. 2012 Dec;178(2):623-631. https://doi.org/10.1016/j.jss.2012.04.062
Misra, Subhasis ; Pedroso, Felipe E. ; Dipasco, Peter J. ; Solomon, Naveenraj L. ; Gennis, Elisabeth ; Franceschi, Dido ; Ardalan, Bach ; Koniaris, Leonidas. / Does neoadjuvant chemotherapy improve outcomes for patients with gastric cancer?. In: Journal of Surgical Research. 2012 ; Vol. 178, No. 2. pp. 623-631.
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abstract = "Background: The role of neoadjuvant and adjuvant therapy for gastric cancer remains undefined. We compared the outcomes for patients treated with surgery alone or with the addition of adjuvant or neaodjuvant treatment. Methods: A single-institution, retrospective evaluation of a prospective database of gastric cancer patients treated from 2000 to 2008 was performed. Results: Overall, 173 patients with gastric cancer underwent surgical extirpation. Of the 173 patients, 43{\%} had early-stage disease (less than stage 2) and 57{\%} had late-stage disease (stage 2 or greater; American Joint Committee on Cancer, 2010). The median survival from the date of diagnosis for those treated with neoadjuvant chemotherapy (NAC) (n = 35), adjuvant chemotherapy (n = 21), adjuvant chemoradiotherapy (n = 18), both NAC and adjuvant chemotherapy (n = 11), or surgery alone (n = 88) was 26.3, 17.3, greater than 60, greater than 60, and 50.3 months, respectively. The addition of NAC to surgery was detrimental to survival in those with early-stage disease (P = 0.002) and did not improve survival in those with late-stage disease (P = 0.687). For those with late-stage disease, surgery with adjuvant chemoradiotherapy exhibited the best overall survival compared with surgery alone (P = 0.021) or surgery with adjuvant chemotherapy (P = 0.01). Patients treated with NAC had a greater rate of R0 resection compared with surgery alone (P = 0.049). Conclusions: NAC for patients with gastric cancer does not significantly improve the overall outcomes for those with late-stage disease and could be detrimental to survival for those with early-stage disease. However, treatment with NAC resulted in an improved rate of R0 resection.",
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AU - Pedroso, Felipe E.

AU - Dipasco, Peter J.

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AU - Gennis, Elisabeth

AU - Franceschi, Dido

AU - Ardalan, Bach

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