BACKGROUND: Gastric cancer often presents in a metastasized stage. We conducted a population-based study to evaluate trends in systemic treatment and survival of metastatic noncardia gastric cancer. PATIENTS AND METHODS: All patients with noncardia adenocarcinoma of the stomach, diagnosed between 1990 and 2011 in the Eindhoven Cancer Registry area in the Netherlands were included (N = 4797). We conducted multivariable logistic regression analysis to evaluate trends in administration of palliative chemotherapy and multivariable proportional hazards regression analyses to evaluate trends in crude overall survival. RESULTS: The proportion of patients presenting with metastatic gastric cancer increased from 24% in 1990 to 44% in 2011 (P < 0.0001). The use of palliative chemotherapy increased, from 5% in 1990 to 36% in 2011, with a strong increase in particular after 2006 (P < 0.0001). Younger patients [<50 years: adjusted odds ratio (ORadj) 3.9, P < 0.001; 50-59 years: ORadj 1.7, P = 0.01] and patients with a high socioeconomic status (ORadj 1.7, P = 0.01) more often received chemotherapy. In contrast, older patients (70-79 years: ORadj 0.3, P < 0.001; 80+ years: ORadj 0.02, P < 0.001), patients with comorbidity (ORadj 0.6, P = 0.03), linitis plastica (ORadj 0.5, P = 0.03) and multiple distant metastases (ORadj 0.5, P = 0.01) were less often treated with chemotherapy. A large hospital variation was observed in the administration of palliative chemotherapy (9%-27%). Median overall survival remained constant between 15 [95% confidence interval (CI) 11.9-17.7] and 17 (95% CI 15.0-20.0) weeks (P = 0.10). CONCLUSIONS: The increased administration of chemotherapy in patients with metastatic gastric cancer did not lead to an increase in population-based overall survival. Identification of the subgroup of patients which benefits from palliative chemotherapy is of utmost importance to avoid unnecessary treatment.
BACKGROUND:Gastric cancer often presents in a metastasized stage. We conducted a population-based study to evaluate trends in systemic treatment and survival of metastatic noncardia gastric cancer. PATIENTS AND METHODS: All patients with noncardia adenocarcinoma of the stomach, diagnosed between 1990 and 2011 in the Eindhoven Cancer Registry area in the Netherlands were included (N = 4797). We conducted multivariable logistic regression analysis to evaluate trends in administration of palliative chemotherapy and multivariable proportional hazards regression analyses to evaluate trends in crude overall survival. RESULTS: The proportion of patients presenting with metastatic gastric cancer increased from 24% in 1990 to 44% in 2011 (P < 0.0001). The use of palliative chemotherapy increased, from 5% in 1990 to 36% in 2011, with a strong increase in particular after 2006 (P < 0.0001). Younger patients [<50 years: adjusted odds ratio (ORadj) 3.9, P < 0.001; 50-59 years: ORadj 1.7, P = 0.01] and patients with a high socioeconomic status (ORadj 1.7, P = 0.01) more often received chemotherapy. In contrast, older patients (70-79 years: ORadj 0.3, P < 0.001; 80+ years: ORadj 0.02, P < 0.001), patients with comorbidity (ORadj 0.6, P = 0.03), linitis plastica (ORadj 0.5, P = 0.03) and multiple distant metastases (ORadj 0.5, P = 0.01) were less often treated with chemotherapy. A large hospital variation was observed in the administration of palliative chemotherapy (9%-27%). Median overall survival remained constant between 15 [95% confidence interval (CI) 11.9-17.7] and 17 (95% CI 15.0-20.0) weeks (P = 0.10). CONCLUSIONS: The increased administration of chemotherapy in patients with metastatic gastric cancer did not lead to an increase in population-based overall survival. Identification of the subgroup of patients which benefits from palliative chemotherapy is of utmost importance to avoid unnecessary treatment.
Authors: Anuradha Vasista; Martin Stockler; Andrew Martin; Nick Pavlakis; Katrin Sjoquist; David Goldstein; Sanjeev Gill; Vikram Jain; Geoffrey Liu; George Kannourakis; Yeul Hong Kim; Louise Nott; Stephanie Snow; Matthew Burge; Dean Harris; Derek Jonker; Yu Jo Chua; Richard Epstein; Antony Bonaventura; Belinda Kiely Journal: Oncologist Date: 2019-04-01
Authors: Anne Schlesinger-Raab; André L Mihaljevic; Silvia Egert; Rebecca T Emeny; Karl-Walter Jauch; Jörg Kleeff; Alexander Novotny; Natascha C Nüssler; Miriam Rottmann; Wolfgang Schepp; Wolfgang Schmitt; Gabriele Schubert-Fritschle; Bernhard Weber; Christoph Schuhmacher; Jutta Engel Journal: J Cancer Res Clin Oncol Date: 2014-03-15 Impact factor: 4.553
Authors: Elias C Padilha; Pranav Shah; Amy Q Wang; Marc D Singleton; Emma A Hughes; Dandan Li; Kelly A Rice; Kylie M Konrath; Samarjit Patnaik; Juan Marugan; Udo Rudloff; Xin Xu Journal: Cancer Chemother Pharmacol Date: 2020-03-17 Impact factor: 3.333
Authors: Mushegh А Sahakyan; Artak Gabrielyan; Davit L Aghayan; Shushan Yesayan; Hmayak Petrosyan; Аlina Chobanyan; Airazat M Kazaryan; Artur M Sahakyan Journal: Indian J Surg Oncol Date: 2019-05-29