Show simple item record

dc.contributor.authorSmyth, EC
dc.contributor.authorFassan, M
dc.contributor.authorCunningham, D
dc.contributor.authorAllum, WH
dc.contributor.authorOkines, AFC
dc.contributor.authorLampis, A
dc.contributor.authorHahne, JC
dc.contributor.authorRugge, M
dc.contributor.authorPeckitt, C
dc.contributor.authorNankivell, M
dc.contributor.authorLangley, R
dc.contributor.authorGhidini, M
dc.contributor.authorBraconi, C
dc.contributor.authorWotherspoon, A
dc.contributor.authorGrabsch, HI
dc.contributor.authorValeri, N
dc.date.accessioned2016-10-18T12:25:30Z
dc.date.issued2016-08-10
dc.identifier.citationJournal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016, 34 (23), pp. 2721 - 2727
dc.identifier.issn0732-183X
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/174
dc.identifier.eissn1527-7755
dc.identifier.doi10.1200/jco.2015.65.7692
dc.description.abstractPURPOSE: The Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial established perioperative epirubicin, cisplatin, and fluorouracil chemotherapy as a standard of care for patients with resectable esophagogastric cancer. However, identification of patients at risk for relapse remains challenging. We evaluated whether pathologic response and lymph node status after neoadjuvant chemotherapy are prognostic in patients treated in the MAGIC trial. MATERIALS AND METHODS: Pathologic regression was assessed in resection specimens by two independent pathologists using the Mandard tumor regression grading system (TRG). Differences in overall survival (OS) according to TRG were assessed using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate analyses using the Cox proportional hazards method established the relationships among TRG, clinical-pathologic variables, and OS. RESULTS: Three hundred thirty resection specimens were analyzed. In chemotherapy-treated patients with a TRG of 1 or 2, median OS was not reached, whereas for patients with a TRG of 3, 4, or 5, median OS was 20.47 months. On univariate analysis, high TRG and lymph node metastases were negatively related to survival (Mandard TRG 3, 4, or 5: hazard ratio [HR], 1.94; 95% CI, 1.11 to 3.39; P = .0209; lymph node metastases: HR, 3.63; 95% CI, 1.88 to 7.0; P < .001). On multivariate analysis, only lymph node status was independently predictive of OS (HR, 3.36; 95% CI, 1.70 to 6.63; P < .001). CONCLUSION: Lymph node metastases and not pathologic response to chemotherapy was the only independent predictor of survival after chemotherapy plus resection in the MAGIC trial. Prospective evaluation of whether omitting postoperative chemotherapy and/or switching to a noncross-resistant regimen in patients with lymph node-positive disease whose tumor did not respond to preoperative epirubicin, cisplatin, and fluorouracil may be appropriate.
dc.formatPrint-Electronic
dc.format.extent2721 - 2727
dc.languageeng
dc.language.isoeng
dc.publisherAMER SOC CLINICAL ONCOLOGY
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectLymph Nodes
dc.subjectHumans
dc.subjectAdenocarcinoma
dc.subjectEsophageal Neoplasms
dc.subjectStomach Neoplasms
dc.subjectLymphatic Metastasis
dc.subjectCisplatin
dc.subjectFluorouracil
dc.subjectEpirubicin
dc.subjectProto-Oncogene Proteins B-raf
dc.subjectReceptor, erbB-2
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectChemotherapy, Adjuvant
dc.subjectNeoadjuvant Therapy
dc.subjectLymph Node Excision
dc.subjectSurvival Rate
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectTumor Suppressor Protein p53
dc.subjectProto-Oncogene Proteins p21(ras)
dc.subjectPTEN Phosphohydrolase
dc.subjectPhosphatidylinositol 3-Kinases
dc.subjectClass I Phosphatidylinositol 3-Kinases
dc.titleEffect of Pathologic Tumor Response and Nodal Status on Survival in the Medical Research Council Adjuvant Gastric Infusional Chemotherapy Trial.
dc.typeJournal Article
dcterms.dateAccepted2016-04-07
rioxxterms.versionofrecord10.1200/jco.2015.65.7692
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2016-08
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfJournal of clinical oncology : official journal of the American Society of Clinical Oncology
pubs.issue23
pubs.notesNo embargo
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics/Signal Transduction & Molecular Pharmacology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Evolutionary Genomics & Modelling
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Gastrointestinal Cancer Biology and Genomics
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics/Signal Transduction & Molecular Pharmacology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Evolutionary Genomics & Modelling
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Gastrointestinal Cancer Biology and Genomics
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume34
pubs.embargo.termsNo embargo
icr.researchteamSignal Transduction & Molecular Pharmacology
icr.researchteamMedicine (RMH Smith Cunningham)
icr.researchteamEvolutionary Genomics & Modelling
icr.researchteamGastrointestinal Cancer Biology and Genomics
dc.contributor.icrauthorLampis, Andrea
dc.contributor.icrauthorHahne, Jens
dc.contributor.icrauthorBraconi, Chiara
dc.contributor.icrauthorValeri, Nicola


Files in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record

https://creativecommons.org/licenses/by/4.0
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0