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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2014

01-04-2014 | Gastrointestinal Oncology

The Prognostic Significance of an R1 Resection in Gastric Cancer Patients Treated with Adjuvant Chemoradiotherapy

Authors: Jurriën Stiekema, MD, Anouk K. Trip, MD, Edwin P. M. Jansen, MD, PhD, Henk Boot, MD, PhD, Annemieke Cats, MD, PhD, Olga Balague Ponz, MD, PhD, Marcel Verheij, MD, PhD, Johanna W. van Sandick, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2014

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Abstract

Background

A microscopically irradical (R1) resection is a well-known adverse prognostic factor after gastric cancer surgery. However, the prognostic significance of an R1 resection in gastric cancer patients who are treated with chemoradiotherapy (CRT) after the operation has been poorly studied. Therefore, the aim of this study was to evaluate the effect of an R1 resection on (recurrence-free) survival in gastric cancer patients who were treated with CRT after surgery.

Methods

Gastric cancer patients who had undergone a resection with curative intent followed by adjuvant CRT at our institute between 2001 and 2011 were included. CRT consisted of radiotherapy (45 Gy/25 fractions) combined with concurrent capecitabine (with or without cisplatin) or 5-fluorouracil/leucovorin.

Results

A consecutive series of 110 patients was studied, including 80 (73 %) patients who had undergone an R0 resection and 30 (27 %) patients with an R1 resection. Pathologic T-classification (p = 0.26), N-classification (p = 0.77), and histologic subtype according to Laurén (p = 0.071) were not significantly different between these groups. Three-year recurrence-free survival (45 vs. 35 %, p = 0.34) and overall survival (47 vs. 48 %, p = 0.58) did not significantly differ between patients who had undergone an R0 or R1 resection. In a multivariate analysis, pathologic T-classification and N-classification were independent prognostic factors for survival.

Conclusions

A R1 resection was not an adverse prognostic factor in gastric cancer patients who had undergone CRT after the operation.
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Metadata
Title
The Prognostic Significance of an R1 Resection in Gastric Cancer Patients Treated with Adjuvant Chemoradiotherapy
Authors
Jurriën Stiekema, MD
Anouk K. Trip, MD
Edwin P. M. Jansen, MD, PhD
Henk Boot, MD, PhD
Annemieke Cats, MD, PhD
Olga Balague Ponz, MD, PhD
Marcel Verheij, MD, PhD
Johanna W. van Sandick, MD, PhD
Publication date
01-04-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3397-4

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