Postoperative chemoradiation therapy

A prospective, multi-institution, phase III trial (SWOG-9008 [NCT01197118]) evaluated postoperative combined chemoradiation therapy versus surgery alone in 559 patients with completely resected stage IB to stage IV (M0) adenocarcinoma of the stomach and gastroesophageal junction. There was a significant survival benefit with adjuvant combined modality therapy.[2][Level of evidence A1] Because the prognosis is relatively favorable for patients with completely resected stage IB disease, the effectiveness of adjuvant chemoradiation therapy for this group is less clear.

A prospective, multi-institution, phase III trial (SWOG-9008 [NCT01197118]) evaluated postoperative combined chemoradiation therapy versus surgery alone in 559 patients with completely resected stage IB to stage IV (M0) adenocarcinoma of the stomach and gastroesophageal junction. There was a significant survival benefit with adjuvant combined modality therapy.[2][Level of evidence A1] Because the prognosis is relatively favorable for patients with completely resected stage IB disease, the effectiveness of adjuvant chemoradiation therapy for this group is less clear.

With more than 10 years of follow-up, median survival was 35 months for the adjuvant chemoradiation therapy group and 27 months for the surgery-alone arm (P = .0046).

A prospective, multi-institution, phase III trial (SWOG-9008 [NCT01197118]) evaluated postoperative combined chemoradiation therapy versus surgery alone in 559 patients with completely resected stage IB to stage IV (M0) adenocarcinoma of the stomach and gastroesophageal junction. There was a significant survival benefit with adjuvant combined modality therapy.[2][Level of evidence A1] Because the prognosis is relatively favorable for patients with completely resected stage IB disease, the effectiveness of adjuvant chemoradiation therapy for this group is less clear.

Median relapse-free survival was 27 months in the chemoradiation arm compared with 19 months in the surgery-alone arm (P < .001). Improvement was primarily seen for locoregional recurrence risk (improvement from 47% for surgery vs. 29% for chemoradiation).[2] However, only 36 patients in the trial had stage IB tumors (18 patients in each arm).[8]