Impact of Adjuvant Chemoradiation Therapy on the Postoperative 5-year Survival Rates for Stage-II Gastric Cancer

2005 ◽  
Vol 5 (4) ◽  
pp. 281
Author(s):  
Seong Kweon Hong ◽  
Min Gew Choi ◽  
Yong Hae Baik ◽  
Jae Hyung Noh ◽  
Tae Sung Sohn ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rates ◽  
Chemoradiation Therapy ◽  
Stage Ii ◽  
Adjuvant Chemoradiation

Cost-effectiveness analysis of gastric cancer management using perioperative chemotherapy versus adjuvant chemoradiation therapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16079-e16079
Author(s):  
Vishnu Prasath ◽  
Patrick L. Quinn ◽  
Joseph B. Oliver ◽  
Omar Mahmoud ◽  
Mohammed Jaloudi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cost Effectiveness ◽  
Treatment Strategy ◽  
Chemoradiation Therapy ◽  
Adjuvant Chemoradiotherapy ◽  
Complication Rates ◽  
Perioperative Chemotherapy ◽  
Adjuvant Chemoradiation ◽  
Cancer Management ◽  
Life Years

e16079 Background: The most commonly used treatment options for gastric cancer include complete resection with adequate margins with either perioperative chemotherapy (PCT) or adjuvant chemoradiotherapy (CRT). While both treatment strategies have shown superiority over surgical resection alone, it is not clear which treatment strategy is more optimal. Methods: Our decision tree model was built to analyze the survival and costs associated with the two major management methods: perioperative chemotherapy and adjuvant chemoradiation therapy. Costs were obtained from Medicare reimbursement rates using a third-party payer perspective. Our model’s effectiveness was represented using quality-adjusted life years (QALYs). Our analysis tested the robustness of our conclusions by utilizing one-way, two-way, and probabilistic sensitivity analyses. Results: PCT was the preferred treatment strategy for diagnosed gastric cancer over CRT, with a cost of $54,326.10 and 4.08 QALYs. CRT was the costliest economic strategy with a cost of $77,987.52 and 4.28 QALYs and an ICER of 115,907.48. We set a threshold of $100,000 per QALYs gained which CRT surpassed making PCT the preferred treatment modality. Over 100,000 simulations, 51.4% of simulations favored PCT. CRT became favored when CRT non-curative procedure rates rose 3% higher than PCT non-curative procedure rates and when PCT complication rates rose 15% higher than CRT complication rates. Conclusions: In our simulated patients with diagnosed gastric cancer, the most cost-effective treatment strategy was PCT. We see cost-effectiveness alternating to favor CRT with changes in non-curative procedure rates and adjuvant therapy complication rates.[Table: see text]

scholarly journals Adjuvant Chemoradiation Therapy in Gastric Cancer: Critically Reviewing the Past and Visualizing the Next Step Forward

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Konstantinos Papadimitriou ◽  
Georgios Antoniou ◽  
Christian Rolfo ◽  
Antonio Russo ◽  
Giuseppe Bronte ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Literature Review ◽  
Combined Therapy ◽  
Chemoradiation Therapy ◽  
Potential Bias ◽  
Adjuvant Chemoradiation ◽  
The Past ◽  
Pros And Cons ◽  
Chemoradiation Treatment

Gastric cancer remains one of the most common malignancies worldwide. Despite the significant advances in surgical treatment and multimodality strategies, prognosis has modestly improved over the last two decades. Locoregional relapse remains one of the main issues and the combined chemoradiation treatment seems to be one of the preferred approaches. However, more than ten years after the hallmark INT-0116 trial, minimal progress has been made both in terms of effectiveness and toxicity. Moreover, new regimens added to combined therapy failed to prove favourable results. Herein, we attempt a thorough literature review comparing pros and cons of all relative studies and potential bias, targeting well-designed future approaches.

scholarly journals Exploratory Analysis to Find Unfavorable Subset of Stage II Gastric Cancer for Which Surgery Alone Is the Standard Treatment; Another Target for Adjuvant Chemotherapy

2014 ◽  
Vol 99 (6) ◽  
pp. 835-841 ◽  
Author(s):  
Toru Aoyama ◽  
Takaki Yoshikawa ◽  
Hirohito Fujikawa ◽  
Tsutomu Hayashi ◽  
Takashi Ogata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Standard Treatment ◽  
Multivariate Analyses ◽  
Survival Rates ◽  
Small Sample ◽  
Stage Ii ◽  
Significant Prognostic Factor ◽  
Tumor Diameter ◽  
Recurrence Free Survival ◽  
Free Survival

Abstract The aim of the present study was to explore the unfavorable subset of patients with Stage II gastric cancer for whom surgery alone is the standard treatment (T1N2M0, T1N3M0, and T3N0M0). Recurrence-free survival rates were examined in 52 patients with stage T1N2-3M0 and stage T3N0M0 gastric cancer between January 2000 and March 2010. Univariate and multivariate analyses were performed to identify risk factors using a Cox proportional hazards model. The recurrence-free survival (RFS) rates of the patients with stages T1N2, T1N3, and T3N0 cancer were 80.0, 76.4, and 100% at 5 years, respectively. The only significant prognostic factor for the survival rates of the patients with stage pT1N2-3 cancer measured by univariate and multivariate analyses was pathological tumor diameter. The 5-year RFS rates of the patients with stage pT1N2-3 cancer were 60.0%, when the tumor diameters measured <30 mm, and 88.9% when the tumor diameters measured >30 mm (P = 0.0248). These data may suggest that pathological tumor diameter is associated with poor survival in patients with small T1N2-3 tumors. Because our study was a retrospective single-center study with a small sample size, a prospective multicenter study is necessary to confirm whether small tumors are risk factor for the RFS in T1N2-3 disease.

Adjuvant chemoradiation therapy (CRT) for resected gastric cancer (GC): A population-based study.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e15569-e15569
Author(s):  
Albert Y. Lin ◽  
Brice Jabo ◽  
Liang Ji ◽  
John S. Macdonald ◽  
Peter Ravdin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Population Based ◽  
Chemoradiation Therapy ◽  
Adjuvant Chemoradiation ◽  
Population Based Study ◽  
Resected Gastric Cancer

THE RESULTS OF TREATMENT OF STAGE II-III DISTAL GASTRIC ADENOCARCINOMA UNDERWENT SURGERY AND POSTOPERATIVE CHEMORADIATION THERAPY

2018 ◽  
Vol 8 (6) ◽  
pp. 15-22
Author(s):  
Duy Phan Canh ◽  
Vu Pham Anh
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Gastric Adenocarcinoma ◽  
Locally Advanced ◽  
Chemoradiation Therapy ◽  
Stage Ii ◽  
Primary Tumors ◽  
Female Ratio ◽  
The Mean ◽  
Postoperative Chemoradiation

Objectives: To evaluate the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiation therapy in stages II-III of distal gastric cancer. Materials & methods: Prospective study on 58 patients with stages II-III gastric adenocarcinoma, underwent distal gastrectomy and D1 or D2 dissection, completed post operative chemoradiation therapy with capecitabine and 4-6 cycles with EOX regimen at Oncology center of Hue central hospital from 01/2013 to 12/2015. Results: Mean age was 55.16 ± 9.1, male/female ratio: 3/1, recurrence was common in the first year after treatment (62.5%), the average time of recurrence and metastasis were 13.50 ± 7.29 months and 18.75 ± 8.97 months, respectively. The mean overall survival was 41.21 ± 21.06 months. The mean disease free survival was 36.22 ± 22.64 months. The mean overall survival: stage II was 41.88 ± 20.78 months; stage III was 39.59 ± 22.27. The mean overall survival for extention of primary tumors: T3 was 40.79 ± 19.61 months; T4 was 41.33 ± 24.80 months. The mean overall survival for extensive of lymph nodes: N (-) was 41.16 ± 20.51 months, N (+) was 41.26 ± 22.06 months. Toxicity levels recorded as follow: leukopenia was mainly on grade 1 and 2 (33.6%), neutropenia was mostly on grade 1 and 2 (26.8%), as well as thrombocytopenia (8.6%); hemoglobin decrease was on grade 1 and 2 in most cases (41.4%); toxicity symptoms on digestive system like nausea-vomitting, diarrhea was mainly on grade 1 and 2. Conclusion: Postoperative chemoradiation therapy helps to improve local and regional recurrence in locally advanced gastric cancer with acceptable toxicities. Key words: Distal gastric adenocarcinoma, postoperative chemoradiation therapy

scholarly journals Neoadjuvant Chemotherapy and Adjuvant Chemoradiation Therapy in the Treatment of Resected Gastric Adenocarcinoma: A Case Series

2017 ◽  
Vol 10 (1) ◽  
pp. 308-315 ◽  
Author(s):  
Christina Hadzitheodorou ◽  
Rebecca A. Moss ◽  
Timothy J. Kennedy ◽  
Salma K. Jabbour
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Gastric Adenocarcinoma ◽  
Case Series ◽  
The United States ◽  
Distant Recurrence ◽  
Chemoradiation Therapy ◽  
Optimal Timing ◽  
Multimodal Approach ◽  
Adjuvant Chemoradiation

The treatment of gastric cancer requires a multimodal approach to decrease the risk of locoregional and distant recurrence. The optimal timing of chemotherapy, surgery, and radiation therapy continues to be explored in ongoing trials. In the United States, surgical resection is often followed by adjuvant chemoradiation therapy or by a combination of neoadjuvant and adjuvant chemotherapy. Here we report on 4 patients with resected gastric adenocarcinoma who were treated with a combination of these 2 approaches, receiving neoadjuvant chemotherapy followed by adjuvant chemoradiation therapy.

Efficacy of Neo- and Adjuvant Treatment Modalities in Gastrointestinal Cancer Patients

Swiss Surgery ◽  
2001 ◽  
Vol 7 (6) ◽  
pp. 239-242
Author(s):  
Mayer
Keyword(s):  
Gastric Cancer ◽  
Rectal Cancer ◽  
Randomized Clinical Trials ◽  
Neoadjuvant Chemoradiation ◽  
Complete Resection ◽  
Chemoradiation Therapy ◽  
Treatment Modalities ◽  
Adjuvant Chemoradiation ◽  
Neoadjuvant Chemoradiation Therapy ◽  
Stage Ii Colon Cancer

Data which have emerged from randomized clinical trials are inconclusive regarding the efficacy of neoadjuvant chemoradiation therapy for patients with esophageal cancer. In 2001, available data appear to support the use of adjuvant chemoradiation therapy following the complete resection of a gastric cancer, adjuvant chemotherapy following the resection of a stage III (and - probably - "high-risk" stage II) colon cancer, and the use of adjuvant (and most likely neoadjuvant) chemoradiation therapy for stages II and III rectal cancer.

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