- Adding preoperative radiotherapy to perioperative chemotherapy (POC) was associated with worse survival in patients with resectable stage IB-IIIC gastric or gastroesophageal junction (GEJ) cancer.
Why this matters
- Retrospective propensity score matching (PSM) analysis of 1048 patients with stage IB-IIIC (excluding T2N0) adenocarcinoma of the stomach (30.9%) or GEJ (69.1%) retrieved from the National Cancer Database.
- Funding: Winship Cancer Institute of Emory University; NCI.
- All received POC; 46.8% also received preoperative radiotherapy.
- Median follow-up, 25.8 months.
- Adding preoperative radiation to POC yielded a greater rate of pathologic complete response (13.1% vs 8.2%; P=.039).
- POC alone was tied to better survival in unmatched groups (HR, 0.83; P=.043).
- In PSM analysis, POC alone was tied to a 30% reduced mortality risk (median OS, 45.1 vs 31.4 months: HR=0.70, P=.016).
- 2-year OS: 72.9% vs 62.5%.
- 5-year OS: 40.7% vs 33.1%.
- In subgroup analyses, survival benefit favoring POC failed to meet statistical significance in PSM gastric cancer (HR, 0.41; P=.07) and GEJ (HR, 0.77; P=.08).
- Retrospective analysis.