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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Adjuvant therapy after curative resection with D2 lymphadenectomy for gastric cancer: Results of a prospective clinical trial

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Department of Surgery
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Department of Oncology
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Department of Pathological Anatomy, Kaunas University of Medicine, Lithuania
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Author to whom correspondence should be addressed.
Medicina 2009, 45(6), 460; https://doi.org/10.3390/medicina45060060
Received: 5 May 2009 / Accepted: 5 June 2009 / Published: 10 June 2009
Objective. Adjuvant chemoradiation for gastric cancer is used more frequently, but there is no general opinion about the effect of this treatment. The aim of this study was to compare adjuvant chemoradiation with adjuvant chemotherapy after radical operation for stomach cancer.
Material and methods. A total of 133 patients were included in this prospective study. Sixty-three patients after curative gastrectomy and D2 lymphadenectomy for gastric cancer were assigned to the chemoradiotherapy group and 70 to the chemotherapy group. The groups were identical by age, sex, and cancer stages. Toxicity was evaluated by the WHO scale, and survival was evaluated by the Kaplan-Meier method.
Results. Grade III and IV toxicity was found more frequently in the chemoradiation group than in the chemotherapy group (44.4% and 7.1%, respectively; P<0.0001). Treatment was not finished in 27% of patients in the chemoradiation group and 11.4% in the chemotherapy group (P=0.03). Overall survival was better in the chemotherapy group as compared with the chemoradiation group (P=0.039). Median survival for patients with stage III and IV cancer was 41 months in the chemotherapy group and 18 months in the chemoradiation group (P=0.085). Survival of patients with stage IIIA cancer in the chemotherapy group was significantly better (P=0.005).
Conclusions. Median survival is shorter in the adjuvant chemoradiation group after curative gastrectomy for gastric cancer as compared with the adjuvant chemotherapy group. Adjuvant chemoradiation is more toxic and should be recommended only for patients with advanced-stage cancer.
Keywords: stomach cancer; curative resection; D2 lymphadenectomy; concomitant chemoradiation; chemotherapy stomach cancer; curative resection; D2 lymphadenectomy; concomitant chemoradiation; chemotherapy
MDPI and ACS Style

Markelis, R.; Endzinas, Ž.; Kiudelis, M.; Grižas, S.; Pundzius, J.; Saladžinskas, Ž.; Juozaitytė, E.; Inčiūra, A.; Pranys, D.; Maleckas, A. Adjuvant therapy after curative resection with D2 lymphadenectomy for gastric cancer: Results of a prospective clinical trial. Medicina 2009, 45, 460.

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