Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/35948
Title: Return to Intended Oncologic Treatment (RIOT) in Resected Gastric Cancer Patients
Authors: RAMOS, Marcus Fernando Kodama PertilleCASTRIA, Tiago Biachi dePEREIRA, Marina AlessandraDIAS, Andre RonconANTONACIO, Fernanda FronzoniZILBERSTEIN, BrunoHOFF, Paulo Marcelo GehmRIBEIRO JR., UlyssesCECCONELLO, Ivan
Citation: JOURNAL OF GASTROINTESTINAL SURGERY, v.24, n.1, p.19-27, 2020
Abstract: Background Postoperative chemotherapy (CMT) or chemoradiotherapy (CRT) is commonly recommended for gastric cancer (GC) patients in order to improve survival. However, some factors that prevent patients from return to intended oncologic treatment (RIOT) may increase the risk of recurrence and decrease the survival benefits achieved with curative resection. The aim of this study was to determine the frequency and factors associated with inability to RIOT and their impact on survival. Methods This retrospective study included stage II/III GC patients treated with potentially curative gastrectomy. Patients who could return to intended oncologic treatment (RIOT group) and those who could not (inability to RIOT group) were analyzed. Results Of the 313 eligible GC patients, 89 (28.4%) and 85 (27.2%) patients receive CRT and CMT, respectively, representing a RIOT rate of 55.6%. The main reason was attributed to general poor performance status (30.2%), followed by surgical postoperative complications (POC) (20.1%). Older age, higher ASA, D1 lymphadenectomy, and major POC were related to inability to RIOT. Older age, neutrophil-lymphocyte ratio (NLR), and major POC were independent risk factors for inability to RIOT. Five-year DFS and OS were worse for the inability to RIOT group than for the RIOT group (p = 0.008 and p = 0.004, respectively). In multivariate analyses, absence of neoadjuvant therapy, total gastrectomy, pT3/T4, pN+, and inability to RIOT were associated with worse DFS. Type of gastrectomy, lymphadenectomy, pN status, Rx resection, and RIOT group were associated with OS. Conclusion Older age, high NLR, and major POC were risk factors for inability to RIOT. RIOT was an independent predictor of survival.
Appears in Collections:Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/24
Artigos e Materiais de Revistas Científicas - LIM/35
Artigos e Materiais de Revistas Científicas - ODS/03

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