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Impact on Survival of Timing and Duration of Adjuvant Chemotherapy in Radically Resected Gastric Cancer

2016; SAGE Publishing; Volume: 102; Issue: 4 Linguagem: Inglês

10.5301/tj.5000480

2038-2529

Maria Di Bartolomeo, Filippo Pietrantonio, Eliana Rulli, Davide Poli, Rosa Berenato, Marta Caporale, Emilio Bajetta, Irene Floriani, Emilio Bajetta, Maria Di Bartolomeo, L. Catena, Massimo Schiavo, G. Pinotti, Ilaria Proserpio, Gerardo Rosati, Roberto Bordonaro, Stefano Cordio, Giovanni Burrafato, Anna Maria Bochicchio, Michele Aieta, Nicola Fazio, Fabio Spada, Vito Amoroso, G Marini, Héctor Soto Parrà, G. Novello, B. Massidda, Maria Teresa Ionta, Mario Comandè, R Venezia, A. Bertolini, E. Menatti, L. Zanlorenzi, Alberto Colombo, A. Iop, Salvatore Bonura, Elena Mazza, Marco Viganò, A. Ardizzoia, Stefania Dell’Oro, Giovanni Lo Re, Davide Adriano Santeufemia, Angela Buonadonna, Dimitri Luisi, G. Ucci, Giuseppe Di Lucca, Andrea Bonetti, Francesca Bergamo, Massimiliano Alú, Francesca Vastola, Paolo Marchetti, D.C. Corsi, Elena Massa, Carmine Pinto, M. Duro, Cristina Oliani, M. Franchini, Alessandro Inzoli, N. Gebbia, Lazzaro Repetto, Selene Rota, L. Frontini, Roberto Labianca, Stefania Mosconi, Antonello Quadri, S. Grossi, Paolo Bidoli, Marina Elena Cazzaniga, Federica Villa, P. Foa, Débora Ferrari, Enrico Aitini, Carla Rabbi, Sandro Barni, F. Petrelli, Mirella Giordano, Giovanna Luchena, M Pirovano, A. Nasisi, V. Catalano, Paolo Giordani, A. Zaniboni, Francesco Leone, Sabrina Ferrario, Giordano Beretta, Ettore Tito Menichetti, D. Conte, D. Mari, Rocco Giannicola, Chiara Pierantoni, Alberto Luporini, Angela Ragazzini, Alessandra Ravaioli, D. Tassinari, Mario Nicolini, D. Amadori, Giovanni Luca Frassineti, D. Turci, F. Zumaglini, Stefano Tamberi, Alessandra Piancastelli, Giorgio Cruciani, E. Bejtja, Alfredo Falcone, Lorenza Landi, Gabriele Minuti, Maurizio Cantore, Lorenza Landi, Andrea Mambrini, A. Ciarlo, D. Cavaciocchi, Francesca Del Monte, Serena Ricci, I. Brunetti, Monica Lencioni, Michele Sisani, Pietro Sozzi, Cristina Granetto, S. Chiara, Alessandra Galetto, Angela Stefania Ribecco, Andrea DeCensi, Lucia Ciuffreda, Enke Baldini, R. Camisa, Renata Todeschini, Armando Santoro, Lorenza Rimassa, Carlo Carnaghi, Tiziana Pressiani, C. Boni, Ermanno Rondini, R. Gnoni, Francesco Di Costanzo, Silvia Gasperoni, Luigi Cavanna, Michael A. Palladino, Rodolfo Mattioli, G. Laici, Francesca Pucci, Manuela Alessio, Ilaria Bernardini, Giovanni Tomasello, G. Baldino, Riccardo Rossetti, S. Giaquinta, Carmine Pinto, Francesca Di Fabio, F.L. Rijas Llimpe, Alba A. Brandes, M. Marzola, Angelo Benevento, S. Competiello, Vincenzo Montesarchio, Antonio Rea, Bruno Daniele, Geppino Genua, M. Licenziato, R. Casaretti, Lucrezia Silvestro, Massimo Montano, M.G. Sarobba, G. Sanna, G. Filippelli, G. Dima, Eulalia Greco, Mario Roselli, D. Natale, G. Condemi, Guglielmo Fumi, S. Tafuto, P. Masullo, D. Nitti, Alberto Marchet, Guido Alberto Massimo Tiberio, Giovanni De Manzoni, Stefania Nobili, Giammaria Fiorentini, Roberto Mazzanti, E. Perrotta, Chiara Carlomagno, Alfonso De Stefano, Giacomo Cartenì, Manel Juan,

Cholangiocarcinoma and Gallbladder Cancer Studies

Purpose Adjuvant chemotherapy improves survival of patients with gastric cancer. Intergroup Trial of Adjuvant Chemotherapy in Adenocarcinoma of the Stomach (ITACA-S) was a phase III study comparing sequential FOLFIRI followed by docetaxel/cisplatin versus 5-fluorouracil monotherapy. The intensive regimen was not superior in terms of disease-free survival (DFS) and overall survival (OS). Methods The treatment was to be started within 8 weeks from surgery. This analysis evaluates the impact of time from surgery to chemotherapy start (TSC) on outcomes. Results Out of 1,106 randomized, 1,072 patients without major violations of eligibility criteria and receiving at least one treatment cycle were analyzed. Median TSC was 50 days. Chemotherapy was interrupted in 201 (18.8%) cases, whereas it was completed without or with modifications in 277 (25.8%) and 594 (55.4%), respectively. At a median follow-up of 56.9 months, 513 progressions and 472 deaths occurred. A longer TSC was significantly associated with longer DFS (hazard ratio [HR] 0.95; 95% confidence interval [CI] 0.89-1.00; p = 0.05) and OS (HR 0.91; 95% CI 0.86-0.97; p = 0.004), after adjustment for treatment arm, age, sex, primary tumor site, number of resected nodes, and tumor stage. Better treatment compliance was associated with improved survival. Conclusions Our findings suggest that longer TSC had at least no detrimental effect on DFS and OS, whereas treatment completion had a protective effect. Our findings need to be confirmed prospectively.