A group of Japanese scientists have assessed 270 patients with unresectable, advanced gastric carcinoma who had received first-line chemotherapy between 1989 and 2001.
The researchers were interested to discover whether the location of a primary tumor has any influence on the effect of chemotherapy in advanced gastric carcinoma.
They carried out their work in light of the observation that patients with localized proximal gastric carcinoma (PGC) have a poorer outcome than those with distal gastric carcinoma (DGC).
PGC was defined as carcinoma located in the upper one third, and DGC as carcinoma located in the lower two thirds of the stomach.
Within the study cohort of 270 patients, a third (91, 33.7%) had PGC, with the remainder (179, 66.3%) having DGC.
The response rate of the primary lesion was 58.6% (51 out of 87) in the PGC group and 35.1% (59 out of 168) in the DGC patients.
The overall response rate for all sites was 55.6% (50 out of 90) in the PGC group and 39.0% (69 out of 177) in the DGC group.
The median survival time was 318 days in the PGC group and 251 days in the DGC group.
Carrying out a multivariate analysis revealed that performance status, extent of disease, and the location of the primary tumor were all significantly related to survival.
The researchers conclude that the response rate and survival time after first-line chemotherapy in advanced gastric carcinoma are better in patients with PGC than in those with DGC.