No survival benefit found with postoperative chemotherapy

Patients with gastric cancer did not experience increased survival after receiving combination chemotherapy after surgery.

Researchers from the Italian Oncology Group for Cancer Research tested the combination of cisplatin, epirubicin, 5-fluorouracil and leucovorin (PELF) in 258 patients with localized gastric cancer. They randomly assigned patients to surgery (n=128) or surgery followed by chemotherapy (n=130) with the PELF combination.

Median follow-up was 72.8 months, at which point there was no difference in disease-free or overall survival in either treatment arm. Five-year overall survival was 47.6% in the chemotherapy group and 48.7% in the control group; five-year disease-free survival was 42.3% in the chemotherapy group and 41.6% in the control group.

Although PELF showed promising results in advanced gastric cancer, in an adjuvant setting the regimen was not successful, the reasearchers concluded. Given their results, the researchers consider adjuvant chemotherapy a controversial method in operable gastric cancer. – by Stacey L. Adams

J Natl Cancer Inst. 2008;100:388-398.