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Neoadjuvant chemotherapy with FOLFOX4 regimen to treat advanced gastric cancer improves survival without increasing adverse events: a retrospective cohort study from a Chinese center.

Sun Z, Zhu RJ, Yang GF, Li Y - ScientificWorldJournal (2014)

Bottom Line: R0 resection, survival, and adverse events were compared.The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05).The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, No. 169 Donghu Road, Wuchang District, Wuhan 430071, China.

ABSTRACT

Background/aim: To evaluate the clinical efficacy of FOLFOX4 (5-fluomumcil/leucovorin combined and oxaliplatin) neoadjuvant chemotherapy for advanced gastric cancer (AGC).

Patients and methods: Fifty-eight AGC patients were enrolled in this retrospective cohort study, 23 in the neoadjuvant group and 35 in the adjuvant group. R0 resection, survival, and adverse events were compared.

Results: The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05). The number of lymph node metastases in the neoadjuvant group (3 (0-14)) was significantly fewer than that in the adjuvant group (6 (0-27)) (P = 0.04). The neoadjuvant group had significantly better median overall survival (29.0 versus 22.0 months) and 3-year survival rate (73.9% versus 40.0%) than the adjuvant group (P = 0.013). The positive expression rate of Ki-67 in the neoadjuvant group (40.0%, 8/20) was lower than that in the adjuvant group (74.2%, 23/31; P = 0.015).

Conclusion: The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

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Related in: MedlinePlus

Kaplan-Meier analysis of the neoadjuvant group and adjuvant group. OS (overall survival) and PFS (progression-free survival) between the two groups ((a), (b)); OS between the two groups without metastasis (c); OS between the two groups with metastasis (d); ((e), (f)) Kaplan-Meier analysis of the Ki-67 positive and negative patients in the neoadjuvant group. Ki-67 negative patients had greater OS benefits than Ki-67 positive patients in the neoadjuvant group (e). There was also a trend towards better PFS benefits in Ki-67 negative patients than positive patients, although the difference did not reach statistical significance (f).
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fig1: Kaplan-Meier analysis of the neoadjuvant group and adjuvant group. OS (overall survival) and PFS (progression-free survival) between the two groups ((a), (b)); OS between the two groups without metastasis (c); OS between the two groups with metastasis (d); ((e), (f)) Kaplan-Meier analysis of the Ki-67 positive and negative patients in the neoadjuvant group. Ki-67 negative patients had greater OS benefits than Ki-67 positive patients in the neoadjuvant group (e). There was also a trend towards better PFS benefits in Ki-67 negative patients than positive patients, although the difference did not reach statistical significance (f).

Mentions: The median followup was 26.0 months (10.0–61.0 months) in the neoadjuvant group and 31.0 months (15.0–72.0 months) in the adjuvant group. The median OS for patients in the neoadjuvant and adjuvant groups were 29.0 months (95% CI, 25.3–32.7 months) and 22.0 months (95% CI, 18.2–25.8 months), respectively. The median PFS were 26.0 months (95% CI, not reached) and 18.0 months (95% CI, 14.4–21.6) respectively. The 3-year OS was 73.9% (95% CI, 54.6%–93.2%) in the neoadjuvant group and 40% (95% CI, 30.1%–49.9%) in the adjuvant group (P = 0.013) (Figure 1(a)). The overall 3-year PFS was 60.9% (95% CI, 47.7%–74.1%) in the neoadjuvant group compared with 34.3% (95% CI, 26.2%–42.4%) in the adjuvant group (P = 0.019) (Figure 1(b)).


Neoadjuvant chemotherapy with FOLFOX4 regimen to treat advanced gastric cancer improves survival without increasing adverse events: a retrospective cohort study from a Chinese center.

Sun Z, Zhu RJ, Yang GF, Li Y - ScientificWorldJournal (2014)

Kaplan-Meier analysis of the neoadjuvant group and adjuvant group. OS (overall survival) and PFS (progression-free survival) between the two groups ((a), (b)); OS between the two groups without metastasis (c); OS between the two groups with metastasis (d); ((e), (f)) Kaplan-Meier analysis of the Ki-67 positive and negative patients in the neoadjuvant group. Ki-67 negative patients had greater OS benefits than Ki-67 positive patients in the neoadjuvant group (e). There was also a trend towards better PFS benefits in Ki-67 negative patients than positive patients, although the difference did not reach statistical significance (f).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4127276&req=5

fig1: Kaplan-Meier analysis of the neoadjuvant group and adjuvant group. OS (overall survival) and PFS (progression-free survival) between the two groups ((a), (b)); OS between the two groups without metastasis (c); OS between the two groups with metastasis (d); ((e), (f)) Kaplan-Meier analysis of the Ki-67 positive and negative patients in the neoadjuvant group. Ki-67 negative patients had greater OS benefits than Ki-67 positive patients in the neoadjuvant group (e). There was also a trend towards better PFS benefits in Ki-67 negative patients than positive patients, although the difference did not reach statistical significance (f).
Mentions: The median followup was 26.0 months (10.0–61.0 months) in the neoadjuvant group and 31.0 months (15.0–72.0 months) in the adjuvant group. The median OS for patients in the neoadjuvant and adjuvant groups were 29.0 months (95% CI, 25.3–32.7 months) and 22.0 months (95% CI, 18.2–25.8 months), respectively. The median PFS were 26.0 months (95% CI, not reached) and 18.0 months (95% CI, 14.4–21.6) respectively. The 3-year OS was 73.9% (95% CI, 54.6%–93.2%) in the neoadjuvant group and 40% (95% CI, 30.1%–49.9%) in the adjuvant group (P = 0.013) (Figure 1(a)). The overall 3-year PFS was 60.9% (95% CI, 47.7%–74.1%) in the neoadjuvant group compared with 34.3% (95% CI, 26.2%–42.4%) in the adjuvant group (P = 0.019) (Figure 1(b)).

Bottom Line: R0 resection, survival, and adverse events were compared.The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05).The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, No. 169 Donghu Road, Wuchang District, Wuhan 430071, China.

ABSTRACT

Background/aim: To evaluate the clinical efficacy of FOLFOX4 (5-fluomumcil/leucovorin combined and oxaliplatin) neoadjuvant chemotherapy for advanced gastric cancer (AGC).

Patients and methods: Fifty-eight AGC patients were enrolled in this retrospective cohort study, 23 in the neoadjuvant group and 35 in the adjuvant group. R0 resection, survival, and adverse events were compared.

Results: The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0-49) versus 13 (3-40)) between the two groups (P > 0.05). The number of lymph node metastases in the neoadjuvant group (3 (0-14)) was significantly fewer than that in the adjuvant group (6 (0-27)) (P = 0.04). The neoadjuvant group had significantly better median overall survival (29.0 versus 22.0 months) and 3-year survival rate (73.9% versus 40.0%) than the adjuvant group (P = 0.013). The positive expression rate of Ki-67 in the neoadjuvant group (40.0%, 8/20) was lower than that in the adjuvant group (74.2%, 23/31; P = 0.015).

Conclusion: The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

Show MeSH
Related in: MedlinePlus