Cancer Research and Treatment

Meta-Analysises

Adjuvant Chemotherapy for Advanced Gastric Cancer in Elderly and Non-elderly Patients: Meta-Analysis of Randomized Controlled Trials: Seong-Hwan Chang, Soo-Nyung Kim, Hye Jung Choi, Misuk Park, Rock Bum Kim, Se-Il Go, Won Sup Lee; Cancer Res Treat. 2017;49(1):263-273. Published online July 5, 2016; DOI: https://doi.org/10.4143/crt.2016.054

Purpose
This study evaluated the benefits of adjuvant chemotherapy on elderly patients with advanced gastric cancer (AGC) using meta-analysis of well-designed randomized controlled clinical studies.
Materials and Methods
PubMed, Embase, and Cochrane were searched to retrieve clinical studies evaluating the benefits of adjuvant chemotherapy in the elderly with AGC. Hazards ratios (HRs) with 95% confidence intervals (CIs) were pooled across studies using a fixed-effects model.
Results
Two studies were included in this meta-analysis to estimate HR for the overall survival (OS), and relapse-free survival (RFS) between adjuvant chemotherapy and surgery in elderly and non-elderly patients. HR for OS in the elderly and non-elderly was 0.745 (95% CI, 0.552 to 1.006, p=0.055) and 0.636 (95% CI, 0.522 to 0.776; p < 0.001), respectively, which showed no heterogeneity regarding HR between the two groups (p_interaction=0.389). HR for RFS in the elderly and non-elderly was 0.613 (95% CI, 0.466 to 0.806; p < 0.001) and 0.633 (95% CI, 0.533 to 0.753; p < 0.001), respectively (p_interaction=0.846).
Conclusion
Meta-analysis suggests that the benefit of adjuvant chemotherapy to the elderly is not big enough to reach statistical significance while the HR for OS is less than 1 (0.745) and no heterogeneity are observed regarding the HR between the elderly and non-elderly patients.

Citations

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Dual-energy CT for evaluating the tumor regression grade of gastric cancer after neoadjuvant chemotherapy
Yuying Lin, Yanfen Lan, Yunyan Zheng, Mingping Ma
European Radiology.2025;[Epub] CrossRef
State of the scientific evidence and recommendations for the management of older patients with gastric cancer
Irene Paredero-Pérez, Paula Jimenez-Fonseca, Juana María Cano, Virginia Arrazubi, Alberto Carmona-Bayonas, Marta Covela-Rúa, Ana Fernández-Montes, Marta Martín-Richard, Regina Gironés-Sarrió
Journal of Geriatric Oncology.2024; 15(3): 101657. CrossRef
Surgical options and survival prognosis in geriatric patients beyond average lifespan with locally advanced gastric cancer: a propensity score-matched analysis
Zhen Tian, Mingyu Xia, Yifan Cheng, Jiajie Zhou, Ruiqi Li, Shuai Zhao, Qiannan Sun, Daorong Wang
Surgical Endoscopy.2024; 38(5): 2756. CrossRef
Prognostic factors and the necessity of chemotherapy for stage II gastric cancer: a model based on multicenter retrospective study
Jiaming Fang, Feiyang Zhang, Jun Lu, Zijian Deng, Xianzhe Li, Xijie Chen, Changming Huang, Yingbo Chen, Lei Lian, Junsheng Peng, Shi Chen
Discover Oncology.2023;[Epub] CrossRef
Adjuvant Chemotherapy in Older Patients with Gastric Cancer: A Population-Based Cohort Study
Wing-Lok Chan, Xiaodong Liu, Carlos King-Ho Wong, Michael Siu-Nam Wong, Ian Yu-Hong Wong, Ka-On Lam, Bryan Ho-Kwan Yun, Emina Edith Cheung, Rosa Pui-Ying Tse, Fion Chan, Simon Law, Dora Kwong
Cancers.2023; 15(15): 3768. CrossRef
The efficacy of adjuvant chemotherapy for older adults with stage II/III gastric cancer: a retrospective cohort study
Yu-Hsuan Shih, Hsin-Chen Lin, Po-Wei Liao, Cheng-Wei Chou, Cheng-Hsien Lin, Chiann-Yi Hsu, Chieh-Lin Jerry Teng, Feng-Hsu Wu, Shao-Ciao Luo, Shao-Hsuan Kao
BMC Cancer.2023;[Epub] CrossRef
Age dependent benefit of neoadjuvant treatment in adenocarcinoma of the esophagus and gastroesophageal junction – a multicenter retrospective observational study of young versus old patients
Ingmar F. Rompen, Nerma Crnovrsanin, Henrik Nienhüser, Kerstin Neuschütz, Lana Fourie, Leila Sisic, Beat P. Müller-Stich, Adrian T. Billeter
International Journal of Surgery.2023;[Epub] CrossRef
Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study
Seohee Choi, Jae-Seok Min, Sang-Ho Jeong, Moon-Won Yoo, Young-Gil Son, Sung Jin Oh, Jong-Han Kim, Joong-Min Park, Hoon Hur, Ye Seob Jee, Sun-Hwi Hwang, Sung-Ho Jin, Sang Eok Lee, Young-Joon Lee, Kyung Won Seo, Sungsoo Park, Chang Min Lee, Chang Hyun Kim,
Journal of Gastric Cancer.2022; 22(1): 67. CrossRef
Considerations and Challenges in the Management of the Older Patients with Gastric Cancer
Sotiris Loizides, Demetris Papamichael
Cancers.2022; 14(6): 1587. CrossRef
Surgical Oncology and Geriatric Patients
Michael E. Johnston, Jeffrey J. Sussman, Sameer H. Patel
Clinics in Geriatric Medicine.2019; 35(1): 53. CrossRef
Optimal treatment for elderly patients with resectable proximal gastric carcinoma: a real world study based on National Cancer Database
Xuefei Wang, Junjie Zhao, Mark Fairweather, Tingsong Yang, Yihong Sun, Jiping Wang
BMC Cancer.2019;[Epub] CrossRef
Thalidomide combined with chemotherapy in treating elderly patients with advanced gastric cancer
Ya Li, Yanjun Chu, Ruifeng Song, Feng Xu
Aging Clinical and Experimental Research.2018; 30(5): 499. CrossRef
Adjuvant chemotherapy with S-1 plus oxaliplatin improves survival of patients with gastric cancer after D2 gastrectomy: A multicenter propensity score-matched study
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World Journal of Clinical Cases.2018; 6(10): 373. CrossRef
Impact of lymph node ratio in selecting patients with resected gastric cancer for adjuvant therapy
Yuhree Kim, Malcolm H. Squires, George A. Poultsides, Ryan C. Fields, Sharon M. Weber, Konstantinos I. Votanopoulos, David A. Kooby, David J. Worhunsky, Linda X. Jin, William G. Hawkins, Alexandra W. Acher, Clifford S. Cho, Neil Saunders, Edward A. Levine
Surgery.2017; 162(2): 285. CrossRef

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15 Web of Science
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Irinotecan Monotherapy Versus Irinotecan-Based Combination as Second-Line Chemotherapy in Advanced Gastric Cancer: A Meta-Analysis: Yo-Han Cho, So Young Yoon, Soo-Nyung Kim; Cancer Res Treat. 2017;49(1):255-262. Published online May 18, 2016; DOI: https://doi.org/10.4143/crt.2015.452

Abstract PDF PubReader ePub

Purpose
A meta-analysis was conducted to examine the question of whether combination regimens are more effective than monotherapy as a second-line chemotherapy in advanced gastric cancer.
Materials and Methods
The MEDLINE and the EMBASE databases and the Cochrane Central Register for Controlled Trials were searched using appropriate keywords. Only randomized controlled trials were eligible.
Results
Taxane-based study is rare; thus, four irinotecan-based studies were finally included in the meta-analysis. Out of 661 patients, 331 patients were assigned to combination therapy and 330 to monotherapy. Cisplatin or fluoropyrimidine (S-1 or 5-fluorouracil) was used as a combination partner to irinotecan. The pooled hazard ratio (HR) for overall survival (OS) and for progression-free survival (PFS) was 0.938 (95% confidence interval [CI], 0.796 to 1.104; p=0.442) and 0.815 (95% CI, 0.693 to 0.958; p=0.013). In subgroup analysis according to previous exposure to a partner agent, the PFS benefit of combination was observed only in the partially exposed group (HR, 0.784; 95% CI, 0.628 to 0.980; p=0.032).
Conclusion
Second-line irinotecan-based combination was not associated with increased OS, but with PFS benefit, which seemed particularly significant for patients receiving combination with a new agent.

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Cancers.2024; 16(22): 3802. CrossRef
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Ramucirumab as Second-Line Therapy in Metastatic Gastric Cancer: Real-World Data from the RAMoss Study
Maria Di Bartolomeo, Monica Niger, Giuseppe Tirino, Angelica Petrillo, Rosa Berenato, Maria Maddalena Laterza, Filippo Pietrantonio, Federica Morano, Maria Antista, Sara Lonardi, Lorenzo Fornaro, Stefano Tamberi, Elisa Giommoni, Alberto Zaniboni, Lorenza
Targeted Oncology.2018; 13(2): 227. CrossRef
Ocoxin oral solution® as a complement to irinotecan chemotherapy in the metastatic progression of colorectal cancer to the liver
Iera Hernandez-Unzueta, Aitor Benedicto, Elvira Olaso, Eduardo Sanz, Cristina Viera, Beatriz Arteta, Joana Márquez
Oncology Letters.2017; 13(6): 4002. CrossRef

11,450 View
217 Download
3 Web of Science
4 Crossref

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