What is the efficacy of combined treatments for gastric cancer?

Updated: Feb 24, 2020
  • Author: Elwyn C Cabebe, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Numerous randomized clinical trials comparing combination chemotherapy in the postoperative setting to surgery alone did not demonstrate a consistent survival benefit.

Meta-analyses have shown a hint of statistical benefit. In one meta-analysis of 13 randomized trials, adjuvant systemic chemotherapy was associated with a significant survival benefit (odds ratio for death, 0.80; 95% CI, 0.66-0.97). In subgroup analysis, there was a trend toward a larger magnitude of effect for trials in which at least two thirds of the patients had node-positive disease. [49]

A study by Bang et al found that adjuvant capecitabine plus oxaliplatin treatment after curative D2 gastrectomy should be considered among patients with operable gastric cancer; however, D2 surgeries are not common in the United States due to morbidity concerns and a lack of level 1 evidence of a survival advantage. [50]


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