Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Adjuvant chemotherapy is beneficial for resectable gastric cancer

This week's Journal of the American Medical Association investigates the benefit of adjuvant chemotherapy for resectable gastric cancer.

News image

fiogf49gjkf04

Despite potentially curative resection of stomach cancer, 50% to 90% of patients die of disease relapse.

Numerous randomized clinical trials have compared surgery alone with adjuvant chemotherapy, but definitive evidence is lacking.

Dr Xavier Paoletti and colleagues from France performed an individual patient-level meta-analysis of all randomized clinical trials to quantify the potential benefit of chemotherapy after complete resection over surgery alone in terms of overall survival and disease-free survival.

The researchers further studied the role of regimens, including monochemotherapy; combined chemotherapy with fluorouracil derivatives, mitomycin C, and other therapies but no anthracyclines.

In addition, the team evaluated the combined chemotherapy with fluorouracil derivatives, mitomycin C, and anthracyclines, and other treatments.

Data was used from all randomized clinical trials comparing adjuvant chemotherapy with surgery alone in patients with resectable gastric cancer.

The research team searched MEDLINE, the Cochrane Central Register of Controlled Trials, the National Institutes of Health trial registry, and published proceedings from major oncologic and gastrointestinal cancer meetings.

5 year overall survival increased from 50% to 55% with chemotherapy
Journal of the American Medical Association
The team identified 31 eligible randomized clinical trials including 6390 patients up to 2004.

Trials testing radiotherapy, neoadjuvant, perioperative, or intraperitoneal chemotherapy, or immunotherapy were excluded.

As of 2010, individual patient data were available from 17 trials with a median follow-up exceeding 7 years.

There were 1000 deaths among 1924 patients assigned to chemotherapy groups and 1067 deaths among 1857 patients assigned to surgery-only groups.

Adjuvant chemotherapy was associated with a statistically significant benefit in terms of overall survival and disease-free survival.

The researchers found no significant heterogeneity for overall survival across randomized clinical trials or the 4 regimen groups, and 5 year overall survival increased from 50% to 55% with chemotherapy.

Dr Paolett's team concluded, "Among the randomized clinical trials included, postoperative adjuvant chemotherapy based on fluorouracil regimens was associated with reduced risk of death in gastric cancer compared with surgery alone."

JAMA 2010: 303(17): 1729-37
12 May 2010

Go to top of page Email this page Email this page to a colleague

 23 February 2018 
Patients on antithrombotic agents undergoing emergency and elective endoscopy
 23 February 2018 
Heavy metals on a gluten-free diet
 23 February 2018 
MRI and NAFLD
 22 February 2018 
Outcomes with Crohn’s after infliximab withdrawal
 22 February 2018 
Elderly onset of IBD

 22 February 2018 
Autophagy enhancers
 21 February 2018 
Management of hemorrhoids in the USA
 21 February 2018 
Adalimumab and infliximab in biologic-naïve Crohn's
 21 February 2018 
Cystic fibrosis and colorectal cancer
 20 February 2018 
Complications and surveillance colonoscopies
 20 February 2018 
Treatment algorithm for polyp cancers
 20 February 2018 
Predictors of postoperative infection in Crohn's
 19 February 2018 
Screening colonoscopy in the right and left colon
 19 February 2018 
NAFLD prevalence in the USA
 19 February 2018 
Fructans in children with IBS

 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us