Chemotherapy improves survival in resectable gastroesophageal cancers

<http://www.ascofoundation.org/ac/1,1003,_12-002123-00_18-0046902-00_19-0046903-00_20-001,00.asp>

Posted: July 05, 2006

NEW YORK (Reuters Health) - Perioperative treatment with epirubicin,
cisplatin, and infused fluorouracil (ECF) can improve progression-free and
overall survival in patients with resectable adenocarcinomas of the lower
esophagus and stomach, new research shows.

Previous reports have shown that ECF can improve the survival of
non-resectable gastric cancer, but it was unclear if this regimen was also
of benefit for operable malignancies.

To investigate, Dr. David Cunningham, from the Royal Marsden Hospital in
London, and colleagues assessed the outcomes of 453 patients who were
randomized to undergo surgery with or without ECF. With ECF, three cycles
of the regimen were given before and after surgery.

The researchers' findings appear in The New England Journal of Medicine
for July 6.

The 30-day mortality rate, as well as the incidence of postoperative
complications, were comparable in each group, the report indicates.

Resected tumors in the ECF group were significantly smaller and less
advanced than those in the control group.

After a median follow-up period of 4 years, 149 patients in the ECF group
and 170 in the control group had died. This equates to a 5-year survival
rate of 36% for the ECF group and 23% for the control group, yielding a
25% reduction in risk with ECF. ECF was also associated with a significant
improvement in progression-free survival (p < 0.001).

In a related editorial, Dr. John S. Macdonald, from St. Vincent's
Comprehensive Cancer Center in New York, comments that the present trial
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."

.

Loading