Highlights
- •Proximal and distal gastric cancers are biologically different but landmark trials have not segregated these.
- •The best approach for distal gastric cancer is debated.
- •There was no difference in OS and DFS between the perioperative and Upfront resection with adjuvant chemotherapy groups.
Abstract
Aim
This study aimed to assess the impact of treatment sequencing on long-term survival,
in distal gastric cancers (GCs) (stage IB/II/III).
Methods
This retrospective study included patients with distal GC undergoing D2 resection.
Outcomes were compared between group 1 (surgery with adjuvant chemotherapy) and group
2 (perioperative chemotherapy with surgery). 1:1 matching for baseline characteristics
(age, cT, and cN stage) was performed for outcome comparison.
Results
At a median follow-up of 47.5 months in the included 342 patients, the 5-year overall
survival (OS) was 61.1% and disease-free survival (DFS) was 50.5%. OS was comparable
in the unmatched (group 1, n = 118; group 2, n = 224) (HR 0.905, 95%CI 0.64–1.33,
P = 0.615) and matched groups (group 1, n = 97; group 2, n = 97) (HR 0.77, 95% CI
0.48–1.26, P = 0.3).
Conclusion
D2 resection followed by adjuvant chemotherapy provides similar long-term outcomes
as compared to perioperative chemotherapy approach for stage IB/II/III distal GCs.
Keywords
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Article info
Publication history
Published online: October 26, 2021
Accepted:
October 22,
2021
Received in revised form:
October 6,
2021
Received:
February 13,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
