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Impact of adjuvant chemoradiation for adenocarcinoma of stomach after curative gastrectomy in Chinese: A 7-year audit




Background and Aim:  Adjuvant chemoradiation (CRT) after curative gastrectomy was introduced to our hospital in 1998. The present study aims to examine the impact of CRT on survival among Chinese.

Methods:  From our gastric cancer registry, patients who received R0 gastrectomy, with UICC stage II or above, M0 disease and ASA grades I and II were analyzed. Adjuvant CRT was offered and given if patients agreed. The regimen consisted of five cycles of 5-fluoruracil (5FU)/leucovorin chemotherapy and 45 Gy/25 fractions concurrent with cycles 2 and 3.

Results:  From January 1998 to December 2004, 134 patients fulfilled the criteria. Sixty had surgery alone and 74 patients received CRT after gastrectomy. One hundred and two (76%) patients received radical gastrectomy with D2 lymphadenectomy. Toxicity ≥ grade 3 was seen in 65% of patients without mortality. The overall and relapse-free 5-year survival rates were 45.8% and 42.0%, respectively. On univariate analysis, early disease stage and adjuvant CRT were associated with better prognosis. Cox regression analysis showed that adjuvant CRT (P = 0.01, HR 2.31, 95% CI: 1.4–3.9) predict better survival after adjustment with the other factors.

Conclusion:  In the present study, postoperative adjuvant chemoradiation is associated with better overall survival in patients with adenocarcinoma of the stomach after curative gastrectomy.