Chemotherapy following surgery appears to significantly improve survival time for patients with gastric cancer, according to a recent article published in the British Journal of Cancer.

The stomach is the primary organ of digestion. It receives food from the esophagus and is located in the upper abdomen. Gastric cancer (stomach cancer) is characterized by the presence of cancer cells in the tissues of the stomach. It is currently the second leading cause of cancer death worldwide.

Surgery remains the essential treatment component for gastric cancer. Recently, however, results from a large pivotal trial indicated a marked improvement for patients who received adjuvant therapy (treatment following surgery) compared with surgery alone

1, as presented at the annual American Society for Therapeutic Radiology and Oncology meeting. Therefore, researchers are evaluating this issue further, in order to define optimal treatment regimens for patients with this disease.

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The concept behind the use of adjuvant therapy arises from the fact that current detection methods are not able to detect small amounts of cancer cells that may be left behind following surgery. These cancer cells are responsible for cancer recurrences. Chemotherapy is considered to be a systemic treatment, meaning its effects reach the entire body. This property enables chemotherapy to potentially kill undetectable cancer cells in patients following surgery.

Researchers conducted a clinical trial to further evaluate the effects of adjuvant chemotherapy in gastric cancer patients. All patients in this trial had cancer that had spread to nearby lymph nodes and were eligible for curative surgery. Half of the patients received combination chemotherapy consisting of epidoxorubicin, leucovorin and 5-fluorouracil for 7 months following surgery while the other half of patients received no adjuvant therapy (control group). Five years following therapy, 30% of the patients receiving adjuvant therapy were still alive compared with only 13% from the control group. The average survival time following treatment was 31 months for patients receiving adjuvant therapy and only 18 months for the control group.

These results are consistent with previous results indicating that the use of adjuvant therapy should become standard of care for patients with gastric cancer. Future clinical trials evaluating different combinations and doses of adjuvant therapies including chemotherapy alone or chemotherapy plus radiation are warranted to establish optimal treatment regimens for patients with gastric cancer. Patients with this disease may wish to speak with their physician about the risks and benefits of adjuvant therapy or the participation in a clinical trial further evaluating this issue. Two sources of information include comprehensive, easy-to-use listing services provided by the National Cancer Institute ( cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. ( British Journal of Cancer, Vol 84, No 7, pp 878-880, 2001) 1 Proceedings from the American Society for Therapeutic Radiology and Oncology annual meeting, 2000, Boston MA)

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