Title |
Tumor regression and survival after perioperative MAGIC-style chemotherapy in carcinoma of the stomach and gastroesophageal junction
|
---|---|
Published in |
BMC Surgery, May 2015
|
DOI | 10.1186/s12893-015-0054-9 |
Pubmed ID | |
Authors |
Fernando Mingol, Javier Gallego, Albina Orduña, Amparo Martinez-Blasco, Javier Sola-Vera, Pedro Moya, Miguel Angel Morcillo, Juan Antonio Ruiz, Rafael Calpena, Francisco-Javier Lacueva |
Abstract |
We assessed the effectiveness of perioperative MAGIC-style chemotherapy in our series focused on the tumor regression grade and survival rate. We conducted a retrospective study of 53 patients following a perioperative regimen of epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/X). Forty-four (83 %) neoplasias were located in the stomach and 9 (17 %) were located at the esophagogastric junction. Perioperative chemotherapy completion, resection, TNM staging, the tumor regression grade (Becker's classification) and survival were analyzed. Forty-five patients (85 %) completed the 3 preoperative cycles. R0 resection was achieved in 42 (79 %) patients. Thirty-five (66 %) patients completed the 3 postoperative cycles. Nine carcinomas (17 %) were considered major responders after preoperative chemotherapy. With multivariate analysis, only completion of perioperative chemotherapy (HR: 0.25; 95%CI: 0.08 - 0.79; p = 0.019) was identified as an independent prognostic factor for disease-specific survival. However, the protective effect of perioperative therapy was lost in patients with ypT3-4 and more than 4 positive lymph nodes (HR: 1.16; 95%CI: 1.02 - 1.32; p = 0.029). The tumor regression grade (major vs minor responders) was at the limit of significance only with univariate analysis. The 5-year overall and disease-specific survival rates were 18 % and 22 % respectively. The percentage of major responder tumors after preoperative chemotherapy was low. Completion of perioperative ECF/X chemotherapy may benefit patients with gastric carcinomas that do not invade the subserosa with few positive lymph nodes. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Science communicators (journalists, bloggers, editors) | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 25 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 6 | 24% |
Student > Master | 4 | 16% |
Other | 3 | 12% |
Student > Doctoral Student | 2 | 8% |
Student > Postgraduate | 2 | 8% |
Other | 7 | 28% |
Unknown | 1 | 4% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 18 | 72% |
Economics, Econometrics and Finance | 2 | 8% |
Unspecified | 1 | 4% |
Nursing and Health Professions | 1 | 4% |
Unknown | 3 | 12% |