Preoperative Chemotherapy Fights Stomach Cancer

A new study shows that chemotherapy improved survival rates in stomach cancer when administered both before and after surgery.

Researchers working at the Royal Marsden Hospital (London and Surrey, UK) examined 503 patients with gastric cancer. Most had tumors in the stomach, while the rest had tumors in the lower esophagus and at the junction of the esophagus and stomach. The study concluded that chemotherapy before and after surgery reduced the risk of death by 25%, compared with patients who underwent surgery alone. The study was published in the July 6, 2006, issue of the New England Journal of Medicine.

The study provides the most substantial clinical evidence yet in support of preoperative therapy for stomach-cancer patients. Chemotherapy given after, but not before, surgery has shown little or no effect on patient survival in previous studies. The researchers found that side effects from the chemo were similar to those reported by other stomach cancer patients. They noted that the chemo combination used--epirubicin, cisplatin, and infused fluorouracil (ECF)--was developed in the 1980s and that newer chemo drugs are now available.

"In patients with operable gastric or lower esophageal adenocarcinomas, a perioperative regimen of ECF decreased tumor size and stage and significantly improved progression-free and overall survival,” said lead author Dr. David Cunningham.

Stomach cancer kills about 700,000 people world-wide each year. The five-year survival rate is only 23%, compared with 65% for all cancers. Stomach cancer remains so deadly because it is typically discovered only in its late stages, when it has most likely extended through the stomach wall and spread to other areas of the gastrointestinal tract.



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