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Published in: Annals of Surgical Oncology 8/2008

01-08-2008 | Gastrointestinal Oncology

7-Year Survival Results of Perioperative Chemotherapy with Epidoxorubicin, Etoposide, and Cisplatin (EEP) in Locally Advanced Resectable Gastric Cancer: Up-to-date Analysis of a Phase-II Study

Authors: Roberto Persiani, MD, Stefano Rausei, MD, Carmelo Pozzo, MD, Alberto Biondi, MD, Carlo Barone, MD, Ferdinando C. M. Cananzi, MD, Giovanni Schinzari, MD, Domenico D’Ugo, MD, FACS

Published in: Annals of Surgical Oncology | Issue 8/2008

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Abstract

Background

Perioperative chemotherapy is considered an effective treatment option for patients with gastric carcinoma. We report the results after a 7-year follow-up of a study aimed at evaluating a perioperative chemotherapy protocol in a group of patients with locally advanced gastric cancer (LAGC).

Methods

Between February 1996 and May 2000, 24 patients with LAGC underwent D2-gastrectomy after three preoperative cycles of chemotherapy (Epidoxorubicin, Etoposide, Cisplatinum). Three further cycles were planned after surgery. Differences among groups were evaluated using the chi-square test. Survival rate was calculated after a 7-year follow-up, and differences were assessed using the log-rank test. Multivariate analysis was performed using the Cox proportional hazard model.

Results

A total of 24 patients received preoperative chemotherapy and underwent surgical resection. Of these, 17 (71%) received postoperative treatment. The main toxicity was grade 3–4 neutropenia. Curative resection (R0) was achieved in 83.3% of patients. No pathologic complete responses were documented, but tumor downstaging was obtained in 10 of 24 patients (41.7%). Overall median survival was 40 months, and 7-year survival rate was 46%. At univariate and multivariate analysis, R0 resection and tumor diameter were the most important prognostic factors.

Conclusion

Long-term results in our series show a survival benefit for LAGC patients treated by perioperative chemotherapy and D2-gastrectomy when compared with previously studied controls who had surgery with postoperative chemotherapy alone. The high rate and prognostic impact of R0 resection in this study stressed the role of the therapy during the preoperative phase.
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Metadata
Title
7-Year Survival Results of Perioperative Chemotherapy with Epidoxorubicin, Etoposide, and Cisplatin (EEP) in Locally Advanced Resectable Gastric Cancer: Up-to-date Analysis of a Phase-II Study
Authors
Roberto Persiani, MD
Stefano Rausei, MD
Carmelo Pozzo, MD
Alberto Biondi, MD
Carlo Barone, MD
Ferdinando C. M. Cananzi, MD
Giovanni Schinzari, MD
Domenico D’Ugo, MD, FACS
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 8/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9982-2

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