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- Title
Early versus Delayed Therapy of Advanced Gastric Cancer Patients - Does It Make a Difference?
- Authors
Elimova, Elena; Shiozaki, Hironori; Slack, Rebecca S.; Chen, Hsiang-Chun; Wadhwa, Roopma; Sudo, Kazuki; Charalampakis, Nikolaos; Hiremath, adarsh; Estrella, Jeannelyn S.; Matamoros, aurelio; Sagebiel, Tara; Das, Prajnan; Rogers, Jane E.; Garris, Jeana L.; Blum, Mariela a.; Badgwell, Brian; ajani, Jaffer a.
- Abstract
Background: Nearly 50% of gastric cancer patients are diagnosed with advanced gastric cancer (AGC). Therapy is palliative but results in ill effects. The median overall survival (OS) of AGC patients is often <12 months. It is unclear if the early initiation of therapy in all AGC patients is beneficial. Methods: A retrospective analysis of AGC patients in our database was carried out. The patients were divided into two groups: asymptomatic or symptomatic. We sought to assess whether the delay of systemic therapy was harmful in asymptomatic patients. Results: A total of 135 patients were analyzed. Most patients were symptomatic (68%), males (67%), and had low ECOG scores (0-1; 85%). In univariate analyses, ECOG performance status 0 (p = 0.005), delayed initiation of therapy (p = 0.03), and lack of symptoms (p = 0.03) were associated with a longer OS. The multivariate model for OS identified only ECOG performance status as an independent prognosticator of longer OS (p = 0.02). Asymptomatic patients who had delayed (≥4 weeks) systemic therapy had an OS rate of 77% at 1 year compared to 58% for patients treated within 4 weeks (p = 0.47). Conclusion: Symptomatic AGC patients had a poor outcome compared to asymptomatic AGC patients. Treatment delay in asymptomatic patients had no detrimental effect on OS, suggesting that the timing of therapy can be based on patient selection. © 2015 S. Karger AG, Basel
- Subjects
TEXAS; CANCER treatment; METASTASIS; ACADEMIC medical centers; CHI-squared test; CONFIDENCE intervals; FISHER exact test; LONGITUDINAL method; MULTIVARIATE analysis; PALLIATIVE treatment; RESEARCH funding; STOMACH tumors; SURVIVAL; PROPORTIONAL hazards models; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; TREATMENT delay (Medicine); KRUSKAL-Wallis Test; TUMOR treatment
- Publication
Oncology, 2015, Vol 89, Issue 4, p215
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000434647