Quimiorradioterapia adyuvante en el cáncer gástrico resecado con intención curativa: Análisis de supervivencia y toxicidad de pacientes tratados entre 1995 y 2003 en el Instituto Nacional del Cáncer, Chile

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Gastric cancer (GC) is a leading cause of cancer death in Chile. Although recommended in international guidelines since 2006, perioperative chemotherapy was not available to patients in the public health system in Chile until 2016. We conducted an observational study to assess the feasibility of this strategy in public hospitals in Chile (Observational Study of Perioperative Chemotherapy in Locally Advanced Gastric Cancer -PRECISO). Patients with locally advanced, operable GC were offered to receive preoperative chemotherapy with Epirubicin + Cisplatin + Capecitabine (ECX) for three cycles followed by curative surgery. Staging included abdominal CT scan and laparoscopy if peritoneal carcinomatosis was suspected. Postoperative ECX for three cycles was recommended. Between August 2010 and March 2013, 110 patients were screened and 61 enrolled. Median age was 62 years (23-76 years) and most patients had good performance status at baseline (Eastern Cooperative Oncology Group performance status score (ECOG) 0: 42, ECOG 1: 19). Tumour site was proximal in 32 (52%) and medial and distal in 29 (48%) patients. All but four patients (n = 57, 93%) completed three cycles of preoperative chemotherapy. Fifty-six patients were operated and 54 (89%) had a curative resection. Thirty-three patients (54%) had pT0-2, and 18 (30%) had pN0 tumours, with two patients achieving a complete response. As of 20 December 2020, 39 patients died, 32 due to GC, one within 30 days of surgery, two due to intestinal obstruction at 5 and 3 months after surgery and four due to other causes. Five-year survival rate was 38%. We conclude that perioperative chemotherapy is feasible in public hospitals in Chile and should be offered to patients with locally advanced GC.

Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Perioperative chemotherapy in locally advanced gastric cancer in Chile: from evidence to daily practice

Müller¹,

Garcı́a²,

Sola³

et al. 2021

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The current situation for gastric cancer in Chile

Caglevic

Silva

Mahave

et al. 2016

Gastric cancer is a neoplasm with a high incidence and mortality rate in Chile where more than 3000 people die every year from this type of cancer. This study shows the clinical and epidemiological considerations of this disease, information about translational research on this pathology in Chile, the contribution of Chilean doctors to the development of gastric cancer management awareness and the general situation of gastric cancer in Chile.

Adjuvant radiochemotherapy in locally advanced gastric cancer: from evidence to daily clinical practice in a single institution

González-Domingo

Ulloa

Olivares

et al. 2020

Background: Gastric cancer is one of the main important causes of cancer death in Chile. Objective: To report the results of adjuvant radiochemotherapy in advanced gastric cancer. Material and Methods: Between 2000 and 2018, 214 subjects aged 23-85 (median, 62) years with lymph node and/or serosa involvement were treated with adjuvant chemoradiotherapy after curative resection. Results: With a median follow-up of 41 months, overall 3-and 5-year survival was 54.9% and 40.85%, respectively. On multivariate analysis, the factors associated with lower survival were aged >65 years, stage group and number of lymph nodes involved. Conclusion: In patients with locoregionally advanced gastric cancer treated with curative intent with surgery and adjuvant radiochemotherapy, the overall 5-year survival reported from local clinical practice is similar to that reported in randomised series and supports its use as an effective treatment for this type of patients in our country.