Dados do Trabalho

Título

Long Term Follow-up of Gastric Cancer Patients treated with Surgery plus Chemoradiation – a Brazilian Single Center Retrospective Study

Introdução

Surgery plus adjuvant chemoradiation (CRT) increases survival in gastric cancer compared to surgery alone.

Objetivo

To report long term data on gastric cancer patients treated with surgery plus adjuvant CRT according to INT-0116 protocol at a large tertiary cancer center in Brazil

Método

This is a retrospective analysis of patients treated for invasive gastric cancer with surgery plus adjuvant CRT according to INT-0116.
Our primary endpoint was overall survival, estimated by the method of Kaplan Meier. Univariate analysis of relevant variables was performed with the log-rank test.

Resultados

From Nov 2009 through Nov 2013, 104 patients were treated according to the INT-0116 protocol. Median follow-up was 72.6 months. Median age was 62 years. Patients were Clinical Stage I in 7%, Stage II in 22% and Stage III in 71% (T3 50%, T4 35%; N2 23% and N3 39%). 38% were operated on at an external institution. D2-dissection was performed in 63% of patients. Histological subtype was intestinal (36%), diffuse (42%) and not otherwise specified (20%).
Median survival was 38.3 months, with 5- and 8-year survival of, respectively, 41% and 38%.
5y-survival in Stage I, II and III were, respectively, 85%, 57% and 31% (p=0.02).
Toxicities were G3 in 24% and G4 in 12% of patients. Most common toxicities were neutropenia (G3 9.6% and G4 9.6%), diarrhea (G3 10.6% and G4 1.9%) and nausea (G3 4.8%).

Conclusão

Our data support the long-term benefit of adjuvant chemoradiotherapy in patients with locally advanced gastric cancer. The survival difference between clinical stages highlights the importance of early diagnosis and treatment of gastric cancer in Brazil.

Palavras-chave

gastric cancer, chemoradiation, radiation, clinical stage