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

BMC Surgery

Research Article

Javier Sola-Vera¹  Javier Gallego²  Albina Orduña³  Juan Antonio Ruiz⁴  Pedro Moya⁵  Amparo Martinez-Blasco⁵  Fernando Mingol⁵  Francisco-Javier Lacueva⁶  Rafael Calpena⁶  Miguel Angel Morcillo⁷ 

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

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

DOI  :  10.1186/s12893-015-0054-9

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

来源: Springer

【 摘 要 】

BackgroundWe assessed the effectiveness of perioperative MAGIC-style chemotherapy in our series focused on the tumor regression grade and survival rate.MethodsWe 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.ResultsForty-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.ConclusionsThe 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】

Unknown   
© Mingol et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.