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Perioperative Chemotherapy Boosts Gastric Cancer Survival

Researchers find it improves survival in patients with resectable gastric cancer

THURSDAY, July 6 (HealthDay News) -- In patients with operable gastroesophageal cancer, perioperative chemotherapy decreases tumor size and stage, and significantly improves overall and progression-free survival, according to a study published in the July 6 issue of the New England Journal of Medicine.

David Cunningham, M.D., of Royal Marsden Hospital in Surrey, U.K., and colleagues studied 503 randomly assigned patients with resectable adenocarcinoma of the stomach, esophagogastric junction or lower esophagus to receive either a perioperative regimen of epirubicin, cisplatin and infused fluorouracil (ECF) and surgery, or surgery alone.

The researchers found that the perioperative-chemotherapy group had significantly smaller and less advanced tumors than the surgery-only group, and had improved rates of overall survival (hazard ratio for death, 0.75), five-year survival (36 percent versus 23 percent) and progression-free survival (hazard ratio for progression, 0.66).

"The most important question for physicians who treat patients with gastric cancer is whether the report by Cunningham et al. should influence their management of the disease. Is perioperative chemotherapy an advance in the treatment of gastric cancer?" states the author of an accompanying editorial. "The trial conducted by Cunningham and colleagues was well designed and well executed, and clinicians can have confidence in the solid evidence that perioperative therapy with a regimen of ECF improves the outcome for patients with resectable gastric cancer identified before gastrectomy."

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