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    The impact of primary tumour origins in patients with advanced oesophageal, oesophago-gastric junction and gastric adenocarcinoma--individual patient data from 1775 patients in four randomised controlled trials.

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    Authors
    Chau, I
    Norman, A R
    Cunningham, D
    Oates, J
    Hawkins, Robert E
    Iveson, T
    Nicolson, M
    Harper, P
    Seymour, M
    Hickish, T
    Affiliation
    Department of Medicine, Royal Marsden Hospital, London.
    Issue Date
    2009-05
    
    Metadata
    Show full item record
    Abstract
    BACKGROUND: It is unclear if differential chemotherapy effects exist on overall survival (OS), response rate (RR) and toxicity depending on primary tumour origin [oesophageal versus oesophago-gastric junction (OGJ) versus gastric adenocarcinoma]. PATIENTS AND METHODS: A total of 2110 patients were enrolled in four randomised controlled trials (RCTs) assessing fluoropyrimidine +/- platinum-based chemotherapy. This analysis used individual patient data and restricted to patients with adenocarcinoma who received one or more dose of chemotherapy. Gastric origin was the control in comparisons of tumour origin. RESULTS: Of the 2110 patients randomised, 1775 (84%) patients had adenocarcinoma with oesophageal (n = 485), OGJ (n = 457) and gastric (n = 833) origins. The median OS was 9.5 months in oesophageal, 9.3 months in OGJ and 8.7 months in gastric cancer (P = 0.68). RR was 44.1% in oesophageal, 41.1% in OGJ and 35.6% in gastric cancers (P = 0.11 and 0.27, respectively, compared with gastric cancer on multivariate analysis). Toxicity composite end point occurred in 46%, 47% and 45% in oesophageal, OGJ and gastric cancers, respectively (P = 0.85 and 0.62 compared with gastric). CONCLUSIONS: In our large multicentre RCT dataset, no significant differences were demonstrated on multivariate analyses in OS, RR and toxic effects among patients with advanced oesophageal, OGJ and gastric adenocarcinoma. Future RCTs should not exclude oesophageal adenocarcinoma.
    Citation
    The impact of primary tumour origins in patients with advanced oesophageal, oesophago-gastric junction and gastric adenocarcinoma--individual patient data from 1775 patients in four randomised controlled trials. 2009, 20 (5):885-91 Ann. Oncol.
    Journal
    Annals of Oncology
    URI
    http://hdl.handle.net/10541/87564
    DOI
    10.1093/annonc/mdn716
    PubMed ID
    19164454
    Type
    Article
    Language
    en
    ISSN
    1569-8041
    ae974a485f413a2113503eed53cd6c53
    10.1093/annonc/mdn716
    Scopus Count
    Collections
    All Paterson Institute for Cancer Research
    Medical Oncology

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