Adjuvant chemotherapy versus preoperative chemotherapy for gastric cancer treated with curative‐intent resection: A propensity score‐matched analysis
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Wiley
2024
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| author | Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos Andre Roncon Dias Osmar Kenji Yagi Amir Zeide Charruf Tiago Biachi de Castria Ulysses Ribeiro |
| author_facet | Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos Andre Roncon Dias Osmar Kenji Yagi Amir Zeide Charruf Tiago Biachi de Castria Ulysses Ribeiro Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos Andre Roncon Dias Osmar Kenji Yagi Amir Zeide Charruf Tiago Biachi de Castria Ulysses Ribeiro |
| collection | Wiley Open Access |
| contents | Adjuvant chemotherapy versus preoperative chemotherapy for gastric cancer treated with curative‐intent resection: A propensity score‐matched analysis Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos Andre Roncon Dias Osmar Kenji Yagi Amir Zeide Charruf Tiago Biachi de Castria Ulysses Ribeiro Journal of Surgical Oncology AbstractBackgroundMultimodal therapy (MMT), comprising surgery alongside perioperative chemotherapy (PCMT) or adjuvant chemotherapy (ACMT), has demonstrated improve in survival compared with surgery alone for advanced gastric cancer (GC). However, the moment of administering chemotherapy for GC is still a matter of debate. This study aimed to compare PCMT and ACMT in patients with locally advanced GC.MethodWe included all gastric adenocarcinoma treated with chemotherapy and curative‐intent resection. Using propensity score matching (PSM), patients who received PCMT were matched with patients undergoing ACMT for 10 pretreatment variables.ResultsAmong the 552 patients with indication for MMT, 377 (68.3%) received combining chemotherapy (CMT): 116 (30.8%) PCMT and 261 (69.2%) ACMT. After PSM, 109 patients were matched in each group. All variables assigned in the score were well matched and both groups became equivalent. Patients receiving PCMT had less angiolymphatic and perineural invasion, less advanced pT, pN and pTNM stage than ACMT group (p < 0.001 for all). There was no difference in the postoperative complication rate between both groups (p = 0.551). After the matching, disease‐free survival (DFS) and overall survival (OS) became similar between PCMT and ACMT groups (DFS: 51.4% vs. 46.9%, p = 0.882, respectively; OS: 54.3% vs. 48.7%, p = 0.638, respectively).ConclusionAfter controlling for pretreatments characteristics, there was no significant difference in survival between GC patients who underwent perioperative and adjuvant CMT. PCMT did not result in an increase in survival, but it provides a decrease in the stage of the disease, with no difference in surgical outcomes. 10.1002/jso.27721 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1002/jso.27721 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_jso_27721 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Adjuvant chemotherapy versus preoperative chemotherapy for gastric cancer treated with curative‐intent resection: A propensity score‐matched analysis Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos Andre Roncon Dias Osmar Kenji Yagi Amir Zeide Charruf Tiago Biachi de Castria Ulysses Ribeiro Journal of Surgical Oncology Adjuvant chemotherapy versus preoperative chemotherapy for gastric cancer treated with curative‐intent resection: A propensity score‐matched analysis Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos Andre Roncon Dias Osmar Kenji Yagi Amir Zeide Charruf Tiago Biachi de Castria Ulysses Ribeiro Journal of Surgical Oncology AbstractBackgroundMultimodal therapy (MMT), comprising surgery alongside perioperative chemotherapy (PCMT) or adjuvant chemotherapy (ACMT), has demonstrated improve in survival compared with surgery alone for advanced gastric cancer (GC). However, the moment of administering chemotherapy for GC is still a matter of debate. This study aimed to compare PCMT and ACMT in patients with locally advanced GC.MethodWe included all gastric adenocarcinoma treated with chemotherapy and curative‐intent resection. Using propensity score matching (PSM), patients who received PCMT were matched with patients undergoing ACMT for 10 pretreatment variables.ResultsAmong the 552 patients with indication for MMT, 377 (68.3%) received combining chemotherapy (CMT): 116 (30.8%) PCMT and 261 (69.2%) ACMT. After PSM, 109 patients were matched in each group. All variables assigned in the score were well matched and both groups became equivalent. Patients receiving PCMT had less angiolymphatic and perineural invasion, less advanced pT, pN and pTNM stage than ACMT group (p < 0.001 for all). There was no difference in the postoperative complication rate between both groups (p = 0.551). After the matching, disease‐free survival (DFS) and overall survival (OS) became similar between PCMT and ACMT groups (DFS: 51.4% vs. 46.9%, p = 0.882, respectively; OS: 54.3% vs. 48.7%, p = 0.638, respectively).ConclusionAfter controlling for pretreatments characteristics, there was no significant difference in survival between GC patients who underwent perioperative and adjuvant CMT. PCMT did not result in an increase in survival, but it provides a decrease in the stage of the disease, with no difference in surgical outcomes. 10.1002/jso.27721 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Adjuvant chemotherapy versus preoperative chemotherapy for gastric cancer treated with curative‐intent resection: A propensity score‐matched analysis |
| topic | Journal of Surgical Oncology |
| url | https://onlinelibrary.wiley.com/doi/10.1002/jso.27721 |