Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma
Abstract Docetaxel, cisplatin, and 5‐fluorouracil (DCF) significantly improved overall survival in metastatic gastroesophageal adenocarcinoma (GEA). The aim of this study was to assess efficacy of DCF regimen as perioperative chemotherapy compared with surgery alone in patients with resectable GEA....
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Online Access: | https://doi.org/10.1002/cam4.885 |
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doaj-270b1f493119446c921d78c91ac3dbb92020-11-25T02:17:52ZengWileyCancer Medicine2045-76342016-11-015113085309310.1002/cam4.885Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinomaFrédéric Fiteni0Sophie Paget‐Bailly1Mathieu Messager2Thierry N'Guyen3Zaher Lakkis4Pierre Mathieu5Najib Lamfichekh6Alain Picard7Bilell Benzidane8Denis Cléau9Franck Bonnetain10Christophe Borg11Christophe Mariette12Stefano Kim13Department of Medical Oncology University Hospital of Besançon Besançon FranceMethodology and Quality of Life in Oncology Unit University Hospital of Besançon Besançon FranceLille University Hospital Department of Digestive Surgery Lille FranceDepartment of Medical Oncology University Hospital of Besançon Besançon FranceDepartment of Digestive Surgery and Liver Transplantation University Hospital of Besançon Besançon FranceDepartment of Digestive Surgery and Liver Transplantation University Hospital of Besançon Besançon FranceDepartment of Surgery Nord Franche Comté Hospital Montbeliard FranceDepartment of Surgery Nord Franche Comté Hospital Belfort FranceDepartment of Oncology and Radiotherapy Nord Franche Comté Hospital Montbeliard FranceDepartment of Gastroenterology Hospital of Vesoul Vesoul FranceMethodology and Quality of Life in Oncology Unit University Hospital of Besançon Besançon FranceDepartment of Medical Oncology University Hospital of Besançon Besançon FranceLille University Hospital Department of Digestive Surgery Lille FranceDepartment of Medical Oncology University Hospital of Besançon Besançon FranceAbstract Docetaxel, cisplatin, and 5‐fluorouracil (DCF) significantly improved overall survival in metastatic gastroesophageal adenocarcinoma (GEA). The aim of this study was to assess efficacy of DCF regimen as perioperative chemotherapy compared with surgery alone in patients with resectable GEA. We identified 789 patients who underwent surgery alone and 62 patients who received at least one cycle of DCF regimen consisting of docetaxel (75 mg/m2 on day 1), cisplatin (75 mg/m2 on day 1), and 5‐fluorouracil (750 mg/m2/day on continuous perfusion on days 1 to 5), every 3 weeks. Overall survival was compared using Cox proportional hazards regression model with adjustments for confounding factors provided by two propensity score methods: inverse probability of treatment weighting (IPTW) and matched‐pair analysis. In Cox multivariate analysis weighted by IPTW, DCF group was associated with favorable overall survival (OS) compared with the surgery group (HR = 0.59; 95% CI, 0.45–0.78; P = 0.0003). For the matched‐pair analysis (comparing 41 patients for each group with the same baseline characteristics), median OS was 22 months and 57 months for the surgery group and DCF group, respectively (log‐rank P = 0.0011). In Cox multivariate analysis, DCF group was associated with favorable OS compared with the surgery group (HR = 0.29; 95% IC, 0.14–0.64; P = 0.0019). In the matched‐pair population, major complications (Dindo‐Clavien grade 3–5) arose in six patients (14.63%) in the DCF group and seven patients (17.07%) in the surgery group (P = 1). Perioperative DCF chemotherapy is superior to surgery alone in terms of OS. A randomized phase III trial should compare DCF to standard perioperative regimens.https://doi.org/10.1002/cam4.885Chemotherapydocetaxelgastric cancerneoadjuvantsurgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Frédéric Fiteni Sophie Paget‐Bailly Mathieu Messager Thierry N'Guyen Zaher Lakkis Pierre Mathieu Najib Lamfichekh Alain Picard Bilell Benzidane Denis Cléau Franck Bonnetain Christophe Borg Christophe Mariette Stefano Kim |
spellingShingle |
Frédéric Fiteni Sophie Paget‐Bailly Mathieu Messager Thierry N'Guyen Zaher Lakkis Pierre Mathieu Najib Lamfichekh Alain Picard Bilell Benzidane Denis Cléau Franck Bonnetain Christophe Borg Christophe Mariette Stefano Kim Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma Cancer Medicine Chemotherapy docetaxel gastric cancer neoadjuvant surgery |
author_facet |
Frédéric Fiteni Sophie Paget‐Bailly Mathieu Messager Thierry N'Guyen Zaher Lakkis Pierre Mathieu Najib Lamfichekh Alain Picard Bilell Benzidane Denis Cléau Franck Bonnetain Christophe Borg Christophe Mariette Stefano Kim |
author_sort |
Frédéric Fiteni |
title |
Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma |
title_short |
Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma |
title_full |
Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma |
title_fullStr |
Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma |
title_full_unstemmed |
Docetaxel, Cisplatin, and 5‐Fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma |
title_sort |
docetaxel, cisplatin, and 5‐fluorouracil as perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma |
publisher |
Wiley |
series |
Cancer Medicine |
issn |
2045-7634 |
publishDate |
2016-11-01 |
description |
Abstract Docetaxel, cisplatin, and 5‐fluorouracil (DCF) significantly improved overall survival in metastatic gastroesophageal adenocarcinoma (GEA). The aim of this study was to assess efficacy of DCF regimen as perioperative chemotherapy compared with surgery alone in patients with resectable GEA. We identified 789 patients who underwent surgery alone and 62 patients who received at least one cycle of DCF regimen consisting of docetaxel (75 mg/m2 on day 1), cisplatin (75 mg/m2 on day 1), and 5‐fluorouracil (750 mg/m2/day on continuous perfusion on days 1 to 5), every 3 weeks. Overall survival was compared using Cox proportional hazards regression model with adjustments for confounding factors provided by two propensity score methods: inverse probability of treatment weighting (IPTW) and matched‐pair analysis. In Cox multivariate analysis weighted by IPTW, DCF group was associated with favorable overall survival (OS) compared with the surgery group (HR = 0.59; 95% CI, 0.45–0.78; P = 0.0003). For the matched‐pair analysis (comparing 41 patients for each group with the same baseline characteristics), median OS was 22 months and 57 months for the surgery group and DCF group, respectively (log‐rank P = 0.0011). In Cox multivariate analysis, DCF group was associated with favorable OS compared with the surgery group (HR = 0.29; 95% IC, 0.14–0.64; P = 0.0019). In the matched‐pair population, major complications (Dindo‐Clavien grade 3–5) arose in six patients (14.63%) in the DCF group and seven patients (17.07%) in the surgery group (P = 1). Perioperative DCF chemotherapy is superior to surgery alone in terms of OS. A randomized phase III trial should compare DCF to standard perioperative regimens. |
topic |
Chemotherapy docetaxel gastric cancer neoadjuvant surgery |
url |
https://doi.org/10.1002/cam4.885 |
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