June 2, 2008 New findings from Oregon Health & Science University Cancer Institute show significant numbers of patients nationwide who are not getting the recommended therapy after surgery to remove stomach cancer.
"We were surprised to learn that there are still many patients who are not receiving the gold standard of chemotherapy and radiation after surgery -- despite compelling clinical data available since 2001. However, it is encouraging to see there has been a significant increase in the use of chemo-radiotherapy since it became the standard of care," said Kristian Enestvedt, M.D., principal investigator, Department of Surgery, OHSU School of Medicine, OHSU Cancer Institute.
One million people die of stomach cancer worldwide each year.
This study by Enestvedt and his colleagues will be presented Sunday, June 1, at 8 a.m. during the annual American Association of Clinical Oncology conference in Chicago.
In 2001 a seminal study showed that using chemotherapy and radiation, also called chemo radiotherapy, after gastric cancer surgery increased survival. Other studies have also recommended that at least 15 lymph nodes should be removed with gastric resection surgery. But little data has existed until now about whether this recommended practice was being followed.
For this study, 313 patient cases were gleaned from a state-wide cancer registry. The chemo/radiation therapy was used only 14.2 percent of the time before 2001 versus, and 33.3 percent after that date.
"That still leaves almost 67 percent of cases left in which patients did not get the appropriate -- and potentially life-extending -- therapy. We found that there was a five-month survival advantage for patients who received chemo radiotherapy," Enestvedt said.
Also, researchers found that only 35 percent of patients had at least 15 nodes removed to check for cancer. The number of lymph nodes removed, however, did not affect survival.
"What patients should know is that they should routinely ask their physicians if their treatment plan includes the latest clinical trial data that pertains to their particular situation," said Charles Thomas, M.D., co-author, chairman and professor of radiation medicine, OHSU School of Medicine, OHSU Cancer Institute member.
Other researchers involved include: Kevin Billingsley, M.D., head of surgical oncology, Hedinger Associate Professor of Surgery, OHSU School of Medicine, OHSU Cancer Institute; Brian Diggs, Ph.D., senior research associate, surgery (general surgery); and Donald K. Shipley, M.S., manager, Oregon State Cancer Registry.
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