Adjuvant chemoradiotherapy after d2-lymphadenectomy for gastric cancer: the role of n-ratio in patient selection. results of a single cancer center

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorCOSTA JR., Wilson L.
dc.contributor.authorCOIMBRA, Felipe J. F.
dc.contributor.authorFOGAROLI, Ricardo C.
dc.contributor.authorRIBEIRO, Heber S. C.
dc.contributor.authorDINIZ, Alessandro L.
dc.contributor.authorBEGNAMI, Maria Dirlei F. L.
dc.contributor.authorMELLO, Celso A. L.
dc.contributor.authorFANELLI, Marcelo F.
dc.contributor.authorSILVA, Milton J. B.
dc.contributor.authorFREGNANI, Jose Humberto
dc.contributor.authorMONTAGNINI, Andre L.
dc.date.accessioned2013-07-30T15:32:23Z
dc.date.available2013-07-30T15:32:23Z
dc.date.issued2012
dc.description.abstractBackground: Adjuvant chemoradiotherapy is part of a multimodality treatment approach in order to improve survival outcomes after surgery for gastric cancer. The aims of this study are to describe the results of gastrectomy and adjuvant chemoradiotherapy in patients treated in a single institution, and to identify prognostic factors that could determine which individuals would benefit from this treatment. Methods: This retrospective study included patients with pathologically confirmed gastric adenocarcinoma who underwent surgical treatment with curative intent in a single cancer center in Brazil, between 1998 and 2008. Among 327 patients treated in this period, 142 were selected. Exclusion criteria were distant metastatic disease (M1), T1N0 tumors, different multimodality treatments and tumors of the gastric stump. Another 10 individuals were lost to follow-up and there were 3 postoperative deaths. The role of several clinical and pathological variables as prognostic factors was determined. Results: D2-lymphadenectomy was performed in 90.8% of the patients, who had 5-year overall and disease-free survival of 58.9% and 55.7%. The interaction of N-category and N-ratio, extended resection and perineural invasion were independent prognostic factors for overall and disease-free survival. Adjuvant chemoradiotherapy was not associated with a significant improvement in survival. Patients with node-positive disease had improved survival with adjuvant chemoradiotherapy, especially when we grouped patients with N1 and N2 tumors and a higher N-ratio. These individuals had worse disease-free (30.3% vs. 48.9%) and overall survival (30.9% vs. 71.4%). Conclusion: N-category and N-ratio interaction, perineural invasion and extended resections were prognostic factors for survival in gastric cancer patients treated with D2-lymphadenectomy, but adjuvant chemoradiotherapy was not. There may be some benefit with this treatment in patients with node-positive disease and higher N-ratio.
dc.description.indexMEDLINE
dc.identifier.citationRADIATION ONCOLOGY, v.7, article ID 169, 9p, 2012
dc.identifier.doi10.1186/1748-717X-7-169
dc.identifier.issn1748-717X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/1150
dc.language.isoeng
dc.publisherBIOMED CENTRAL LTD
dc.relation.ispartofRadiation Oncology
dc.rightsopenAccess
dc.rights.holderCopyright BIOMED CENTRAL LTD
dc.subject.otheroral fluoropyrimidine
dc.subject.otheradenocarcinoma
dc.subject.otherchemotherapy
dc.subject.otherrecurrence
dc.subject.otherchemoradiation
dc.subject.otherpopulation
dc.subject.otherdissection
dc.subject.othercarcinoma
dc.subject.otherresection
dc.subject.otherstomach
dc.subject.wosOncology
dc.subject.wosRadiology, Nuclear Medicine & Medical Imaging
dc.titleAdjuvant chemoradiotherapy after d2-lymphadenectomy for gastric cancer: the role of n-ratio in patient selection. results of a single cancer center
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalCOSTA JR., Wilson L.:Hosp AC Camargo Fund Antonio Prudente, Dept Abdominal Surg, Sao Paulo, Brazil
hcfmusp.author.externalCOIMBRA, Felipe J. F.:Hosp AC Camargo Fund Antonio Prudente, Dept Abdominal Surg, Sao Paulo, Brazil
hcfmusp.author.externalFOGAROLI, Ricardo C.:Hosp AC Camargo Fund Antonio Prudente, Dept Radiotherapy, Sao Paulo, Brazil
hcfmusp.author.externalRIBEIRO, Heber S. C.:Hosp AC Camargo Fund Antonio Prudente, Dept Abdominal Surg, Sao Paulo, Brazil
hcfmusp.author.externalDINIZ, Alessandro L.:Hosp AC Camargo Fund Antonio Prudente, Dept Abdominal Surg, Sao Paulo, Brazil
hcfmusp.author.externalBEGNAMI, Maria Dirlei F. L.:Hosp AC Camargo Fund Antonio Prudente, Dept Surg Pathol, Sao Paulo, Brazil
hcfmusp.author.externalMELLO, Celso A. L.:Hosp AC Camargo Fund Antonio Prudente, Dept Clin Oncol, Sao Paulo, Brazil
hcfmusp.author.externalFANELLI, Marcelo F.:Hosp AC Camargo Fund Antonio Prudente, Dept Clin Oncol, Sao Paulo, Brazil
hcfmusp.author.externalSILVA, Milton J. B.:Hosp AC Camargo Fund Antonio Prudente, Dept Clin Oncol, Sao Paulo, Brazil
hcfmusp.author.externalFREGNANI, Jose Humberto:Barretos Canc Hosp, Ctr Researcher Support, Barretos, Brazil
hcfmusp.citation.scopus17
hcfmusp.contributor.author-fmusphcANDRE LUIS MONTAGNINI
hcfmusp.description.articlenumber169
hcfmusp.description.volume7
hcfmusp.origemWOS
hcfmusp.origem.pubmed23068190
hcfmusp.origem.scopus2-s2.0-84867392780
hcfmusp.origem.wosWOS:000313970100001
hcfmusp.publisher.cityLONDON
hcfmusp.publisher.countryENGLAND
hcfmusp.relation.referenceCoimbra FJF, 2011, EJSO-EUR J SURG ONC, V37, P47, DOI 10.1016/j.ejso.2010.11.002
hcfmusp.relation.referenceCosta MLV, 2006, ANN SURG ONCOL, V13, P843, DOI 10.1245/ASO.2006.05.040
hcfmusp.relation.referenceD'Angelica M, 2004, ANN SURG, V240, P808, DOI 10.1097/01.sla.0000143245.28656.15
hcfmusp.relation.referenceDicken BJ, 2005, ANN SURG, V241, P27, DOI 10.1097/01.sla.0000149300.28588.23
hcfmusp.relation.referenceEdwards P, 2004, BRIT J CANCER, V90, P1888, DOI 10.1038/sj.bjc.6601790
hcfmusp.relation.referenceHundahl SA, 2002, ANN SURG ONCOL, V9, P278, DOI 10.1245/aso.2002.9.3.278
hcfmusp.relation.referenceKim CY, 2009, ANN SURG ONCOL, V16, P1868, DOI 10.1245/s10434-009-0430-8
hcfmusp.relation.referenceKim S, 2005, INT J RADIAT ONCOL, V63, P1279, DOI 10.1016/j.ijrobp.2005.05.005
hcfmusp.relation.referenceKnight Greg, 2013, Gastric Cancer, V16, P28, DOI 10.1007/s10120-012-0148-3
hcfmusp.relation.referenceLee J, 2011, J CLIN ONCOL, V30, P268
hcfmusp.relation.referenceLi W, 2010, WORLD J GASTROENTERO, V16, P5621, DOI 10.3748/wjg.v16.i44.5621
hcfmusp.relation.referenceMacdonald JS, 2001, NEW ENGL J MED, V345, P725, DOI 10.1056/NEJMoa010187
hcfmusp.relation.referenceMarchet A, 2007, ANN SURG, V245, P543, DOI 10.1097/01.sla.0000250423.43436.e1
hcfmusp.relation.referenceMuratore A, 2009, EJSO-EUR J SURG ONC, V35, P588, DOI 10.1016/j.ejso.2008.12.012
hcfmusp.relation.referenceSakuramoto S, 2007, NEW ENGL J MED, V357, P1810, DOI 10.1056/NEJMoa072252
hcfmusp.relation.referenceSasako M, 2009, GASTRIC CANCER, V12, P10, DOI 10.1007/s10120-008-0465-8
hcfmusp.relation.referenceScartozzi M, 2006, BRIT J CANCER, V95, P445, DOI 10.1038/sj.bjc.6603286
hcfmusp.relation.referenceSobin LH, 2010, INT UNION CANC UICC, P73
hcfmusp.relation.referenceSongun I, 2010, LANCET ONCOL, V11, P439, DOI 10.1016/S1470-2045(10)70070-X
hcfmusp.relation.referenceTsang WK, 2007, CLIN ONCOL-UK, V19, P333, DOI 10.1016/j.clon.2007.03.004
hcfmusp.relation.referenceYoo CH, 2000, BRIT J SURG, V87, P236, DOI 10.1046/j.1365-2168.2000.01360.x
hcfmusp.relation.referenceYoshinori N, 1993, ANN SURG, V218, P47
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