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Post-Op Chemo Fails to Boost Survival in Stomach Cancers

Drug-surgery combo showed no significant improvement in outcomes, study finds

TUESDAY, March 11 (HealthDay News) -- Chemotherapy following surgery does not improve survival in stomach cancer patients, says an Italian study.

Currently, surgery is the only treatment that can potentially cure non-metastatic gastric cancer, according to background information in the study. However, some recent research has suggested that a chemotherapy combination of cisplatin, epirubicin, 5-fluorouracil and leucovorin (PELF) improves outcomes in people with metastatic gastric cancer.

In this study, researchers tested the PELF combination in patients with localized gastric cancer. Some of the 258 patients in the study were treated with surgery only, while others had surgery followed by chemotherapy.

At a median follow-up of 72.8 months, there was no statistical difference between the two groups in terms of disease-free survival or overall survival. Disease progression occurred in 47.7 percent of patients in the surgery/chemotherapy group and in 51.6 percent of those in the surgery group.

The survival rate was 47 percent in the surgery/chemotherapy group and 45.3 percent in the surgery group.

The study was published in the March 11 online issue of the Journal of the National Cancer Institute.

"Our study confirms that a dose-intense regimen like PELF, which showed very promising results in advanced gastric cancer, is not effective in an adjuvant setting," wrote the researchers from the University Hospital Careggi in Florence and the Italian Oncology Group for Cancer Research. Based on these and other recent negative findings, the authors concluded: "Adjuvant chemotherapy alone remains a controversial approach in operable gastric cancer."

In an accompanying editorial, two doctors at the Beijing Cancer Hospital and Institute in China discuss conflicting findings from recent trials examining the use of chemotherapy and radiation to treat patients with localized gastric cancer.

Even though overall data is inconsistent, chemotherapy, radiation or a combination of the two should be used in patients with localized gastric cancer, said Dr. Aiwen Wu and Dr. Jiafu Ji.

"Surgery alone is no longer the standard treatment for patients with resectable gastric cancer, independent of the patient population or the practice location," they wrote.

More information

The American Cancer Society has more about stomach cancer.

-- Robert Preidt

SOURCE: Journal of the National Cancer Institute, news release, March 11, 2008

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