ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2025
Perioperative versus adjuvant chemotherapy in carcinoma stomach-A retrospective propensity-matched analysis.
Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Tree-based model for diffuse-type gastric cancer prognostication: a population study based on the Surveillance, Epidemiology, and End Results database.Translational cancer research · 2026Article
- Gastric cancer and the TNT era: have we solved the timing question, or only redistributed the treatment?Frontiers in oncology · 2026Article
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Abstract
backgroundA uniform consensus on the optimal sequencing of treatment modalities in locally advanced gastric cancer is not reached due to conflicting results worldwide. We conducted a retrospective propensity-matched analysis to compare survival of locally advanced gastric cancer patients who were treated with peri-operative chemotherapy followed by surgery or upfront surgery followed by adjuvant chemotherapy.
methodsDeidentified records of prospectively maintained data of locally advanced gastric cancer patients treated from 2015 to 2020 were collected. A 1:1 propensity matching with a tolerance limit of 0.2 was performed. The outcome variables including recurrence-free and overall survival were compared among the matched groups using log-rank tests and Cox proportional hazards analysis was performed.
resultsTwo hundred patients (64 in peri-operative chemotherapy and 136 in the upfront surgery group) were included in the study. Variables including age group, sex, gastric outlet obstruction, tumor site, clinical T stage and node positivity were used for matching. The median overall survival and recurrence-free survival were found to be 21.90 months (95% CI = 13.30-30.49) and 15.08 months (95% CI = 8.17-21.98), respectively, in the peri-operative chemotherapy arm and 18.70 months (95% CI = 11.88-25.51) and 13.49 months (95% CI = 6.76-20.21), respectively, in upfront surgery arm with no significant difference (median follow-up 42 months). Patients who presented with pallor had Borrmann type 4 on endoscopy, received lesser number of chemotherapy cycles, lymph node ratio was > 0.13 and perineural invasion were associated with worse overall survival and recurrence-free survival.
conclusionIn this real-world scenario, retrospective propensity-matched study, no difference was noted in overall survival and recurrence-free survival between patients who received peri-operative chemotherapy or upfront surgery followed by adjuvant chemotherapy in locally advanced gastric cancer.
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