Perioperative Chemotherapy versus Surgery Alone for Resectable Gastroesophageal Cancer

摘要: Background A regimen of epirubicin, cisplatin, and infused fluorouracil (ECF) improves survival among patients with incurable locally advanced or metastatic gastric adenocarcinoma. We assessed whether the addition a perioperative ECF to surgery outcomes potentially curable cancer. Methods randomly assigned resectable adenocarcinoma stomach, esophagogastric junction, lower esophagus either chemotherapy (250 patients) alone (253 patients). Chemotherapy consisted three preoperative postoperative cycles intravenous epirubicin (50 mg per square meter body-surface area) cisplatin (60 meter) on day 1, continuous infusion (200 day) for 21 days. The primary end point was overall survival. Results ECF-related adverse effects were similar those previously reported Rates complications in perioperative-chemotherapy group (46 percent 45 percent, respectively), as numbers deaths within 30 days after surgery. resected tumors significantly smaller less group. With median follow-up four years, 149 170 had died. As compared group, higher likelihood (hazard ratio death, 0.75; 95 confidence interval, 0.60 0.93; P = 0.009; five-year rate, 36 vs. 23 percent) progression-free progression, 0.66; 0.53 0.81; P<0.001). Conclusions In operable esophageal adenocarcinomas, decreased tumor size stage improved (Current Controlled Trials number, ISRCTN93793971.)