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Postoperative chemoradiation improved survival in gastric cancer
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Patients treated with chemoradiation after surgery for gastric cancer demonstrated better OS compared with patients who underwent post-operative chemotherapy, according to results of a retrospective study.
Timothy Pawlik, MD, MPH, PhD, professor of surgery at Johns Hopkins University School of Medicine, and colleagues pooled data on 505 patients (mean age, 62 years; 58.2% male) treated for gastric cancer between 2000 and 2012.
They used the multi-institutional US Gastric Cancer Collaborative database to analyze data on patient age, tumor size and other factors, and they used propensity-score matching to compare survival rates.
Timothy Pawlik
The investigators compared the outcomes between patients who underwent chemoradiation (n=294) and those who underwent chemotherapy (n=211). Median follow-up was 28 months.
Overall, 38.7% of patients had a category T3 lesion, 36.8% had a T4 lesion and 73.4% had lymph node metastasis.
The overall median OS was 33.4 months and median 5-year OS was 36.7 %.
Researchers reported longer median survival (46.7 months vs. 20.9 months; HR=0.51; P<.001) and a higher rate of 5-year OS (46.9% vs. 24.9%) among patients who underwent postoperative chemoradiation.
Median RFS was 35.6 months in the chemoradiation arm compared with 16.6 months in the chemotherapy arm.
Large tumor size (HR=1.83), category T3 tumor (HR=2.96), category T4 tumor (HR=4.02) and lymph node metastasis (HR=1.57; P<.05 for all) all were associated with shorter OS. Patients who underwent chemoradiation were more likely to be younger age (OR=1.93) and have lymph node metastasis (OR=4.02; P<.05 for both).
“The addition of radiation especially improved survival rates among gastric cancer patients whose cancers had spread to lymph nodes in the immediate region of the stomach,” Pawlik said in a press release.
He added that, although the use of radiation therapy in treating gastric cancer is not well studied, “these data would suggest that radiation therapy would benefit patients, in particular those patients who had disease that has spread to lymph nodes.”
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.
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