Though endorsed by guidelines, adjuvant chemotherapy ± radiotherapy (C±RT) for early-stage gastric cancer remains underused nationally, according to an analysis involving more than 23,000 individuals.
Using the National Cancer Database for patients with stage IB to II gastric adenocarcinoma who underwent gastrectomy, investigators looked at overall survival by treatment type. Among the results:
• 79% had surgery only, 18% had chemoradiotherapy, and the remainder had chemotherapy alone.
• Those who had C±RT tended to be <67 years of age, have positive nodes, and adequate lymph node staging.
• Those who didn’t receive C±RT had an increased risk of mortality.
• C±RT benefit was most distinct in people with stage II and node-positive regardless of lymph node staging adequacy, as well as inadequately staged IB patients.
• Adjuvant C±RT did not improve overall survival in those with negative nodes if surgical lymph node staging was adequate.
Citation: Datta J, McMillan M, Ruffolo L, et al. Multimodality therapy improves survival in resected early stage gastric cancer in the United States. [Published online ahead of print April 18, 2016]. Ann Surg Oncol. doi:10.1245/s10434-016-5224-1.