- A Western study shows a survival benefit for adjuvant chemotherapy (ACT) and adjuvant chemoradiation therapy (CRT) in patients with pT1N1 gastric adenocarcinoma (GAC), after studies in South Korea showed no apparent benefit.
Why this matters
- Eastern and Western populations are known to have significant disparities in gastric cancer outcomes.
- Retrospective comparison between 4516 patients with pT1N0 GAC and 696 patients with pT1N1 GAC identified from the National Cancer Database (2004-2012).
- Funding: University of Texas Southwestern Medical Center.
- Patients with pT1N0 GAC were more likely to undergo observation than those with pT1N1 disease (98.1% vs 47.4%; P<.001>
- pT1N1 GAC was more commonly treated with ACT (ACT, 11.1% vs 0.9%), adjuvant radiation therapy (ART: 9.8% vs 0.4%), and adjuvant CRT (31.8% vs 0.6%; P<.001 for all>
- ACT and adjuvant CRT were independently associated with improved OS in pT1N1 disease after adjustment for other clinicopathological factors:
- ACT: HR, 0.37 (95% CI, 0.22-0.65).
- ACRT: HR, 0.40 (95% CI, 0.28-0.57).
- No survival benefit was observed for ART in pT1N1 disease.
- Study was observational and retrospective.