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A meta-analysis of the association between adjuvant chemoradiotherapy and disease-free survival in gastric cancer according to the histology

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Abstract

Background

There are biological distinctions between gastric cancers from Eastern and Western nations, and therapeutic strategies may differ regionally. Perioperative chemotherapy, adjuvant chemotherapy, and adjuvant chemoradiotherapy (CRT) have all been demonstrated to be effective in the treatment of gastric cancer. The goal of this study was to do a meta-analysis of published studies that were eligible to see if adjuvant chemoradiotherapy was helpful for gastric cancer based on the cancer’s histology.

Method

From inception to May 4, 2022, manual searches were conducted to identify all eligible literature using the PubMed database for the published phase III clinical trial and a randomize-controlled trial testing the role of adjuvant chemoradiotherapy in operable gastric cancer.

Results

Two trials with a total of 1004 patients were selected as a result. Adjuvant CRT was found to have no effect on disease-free survival (DFS) in gastric cancer patients treated with D2 surgery (HR: 0.70 (0.62–1.02), p: 0.07). However, patients with intestinal-type gastric cancers exhibited significantly longer DFS (HR: 0.58 (0.37–0.92), p = 0.02).

Discussion

After D2 dissection, adjuvant CRT improved DFS in patients with intestinal-type gastric cancers but not in those with diffuse-type gastric cancers.

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References

  1. Zhu AL, Sonnenberg A (2012) Is gastric cancer again rising? J Clin Gastroenterol 46(9):804–806

    Article  PubMed  Google Scholar 

  2. Al-Batran S-E et al (2019) Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet 393(10184):1948–1957

    Article  Google Scholar 

  3. Park SH et al (2015) Phase III trial to compare adjuvant chemotherapy with capecitabine and cisplatin versus concurrent chemoradiotherapy in gastric cancer: final report of the adjuvant chemoradiotherapy in stomach tumors trial, including survival and subset analyses. J Clin Oncol 33(28):3130–3136

    Article  PubMed  CAS  Google Scholar 

  4. Park S et al (2021) A randomized phase III trial comparing adjuvant single-agent S1, S-1 with oxaliplatin, and postoperative chemoradiation with S-1 and oxaliplatin in patients with node-positive gastric cancer after D2 resection: the ARTIST 2 trial. Ann Oncol 32(3):368–374

    Article  PubMed  CAS  Google Scholar 

  5. Woo J-W et al (2014) Prognostic impact of microscopic tumor involved resection margin in advanced gastric cancer patients after gastric resection. World J Surg 38(2):439–446

    Article  PubMed  Google Scholar 

  6. Coburn NG et al (2006) Significant regional variation in adequacy of lymph node assessment and survival in gastric cancer. Cancer: Interdisciplinary Int J Am Cancer Soc 107(9):2143–2151

  7. Yildirim H et al (2022) Prognostic factors associated with locally advanced gastric cancer in patients treated with adjuvant chemotherapy. J Oncol Sci 8(3)

  8. Bu Z et al (2013) Lymphatic vascular invasion is an independent correlated factor for lymph node metastasis and the prognosis of resectable T2 gastric cancer patients. Tumor Biol 34(2):1005–1012

    Article  CAS  Google Scholar 

  9. Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma: an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 64(1):31–49

    Article  PubMed  CAS  Google Scholar 

  10. Smalley SR et al (2012) Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Oncol 30(19):2327

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Cats A et al (2018) Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial. Lancet Oncol 19(5):616–628

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Oncology, Hacettepe University Cancer Institute, 06100, Sihhiye, Ankara, Turkey

    Hasan Cagri Yildirim, Deniz Can Guven, Arif Akyildiz, Suayib Yalcin & Omer Dizdar

Authors
  1. Hasan Cagri Yildirim
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  2. Deniz Can Guven
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  3. Arif Akyildiz
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  4. Suayib Yalcin
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  5. Omer Dizdar
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Corresponding author

Correspondence to Hasan Cagri Yildirim.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare no competing interests.

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Yildirim, H.C., Guven, D.C., Akyildiz, A. et al. A meta-analysis of the association between adjuvant chemoradiotherapy and disease-free survival in gastric cancer according to the histology. Ir J Med Sci 192, 2631–2634 (2023). https://doi.org/10.1007/s11845-023-03297-7

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  • DOI: https://doi.org/10.1007/s11845-023-03297-7

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