Tumor regression and survival after perioperative MAGIC-style chemotherapy in carcinoma of the stomach and gastroesophageal junction

BMC Surgery

Francisco-Javier Lacueva²  Rafael Calpena²  Juan Antonio Ruiz⁴  Miguel Angel Morcillo³  Pedro Moya⁵  Javier Sola-Vera⁶  Amparo Martinez-Blasco⁵  Albina Orduña¹  Javier Gallego²  Fernando Mingol⁵ 

[1] Pathology Department, Elche University Hospital, Elche, Spain;Pathology and Surgery Department, Miguel Hernandez University of Elche, Elche, Spain;Surgery Department, Vega Baja Hospital, Elche, Spain;Pathology Department, Vega Baja Hospital, Elche, Spain;Surgery Department, Elche University Hospital, Elche, Spain;Gastroenterology Department, Elche University Hospital, Elche, Spain

关键词: Survival;    Tumor regression;    Surgery;    ECF/X regimen;    Perioperative chemotherapy;    Gastric cancer;   

Others  :  1204291
DOI  :  10.1186/s12893-015-0054-9

 received in 2014-08-09, accepted in 2015-05-13,  发布年份 2015

【 摘 要 】

Background

We assessed the effectiveness of perioperative MAGIC-style chemotherapy in our series focused on the tumor regression grade and survival rate.

Methods

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.

Results

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.

Conclusions

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.

【 授权许可】

   
2015 Mingol et al.; licensee BioMed Central.

【 图 表 】

Fig. 1.

Fig. 2.

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