Post progression survival analysis of metastatic gastric and gastroesophageal junction cancer patients after second-line treatment

Acta Gastroenterol Belg. 2016 Apr-Jun;79(2):211-5.

Abstract

Purpose: The aim of this study was to define the factors that -affect response and post-progression survival of metastatic gastric cancer (MGC) and gastroesophageal junction cancer (GEJ) -patients treated with second-line chemotherapy.

Methods: We retrospectively reviewed the data of 59 patients with MGC or GEJ adenocarcinoma who received second-line treatment.

Results: The median age was 54 years old (26-77). Response to second-line treatment was strongly associated with disease control with first-line treatment (p < 0.01). Median progression-free survival (PFS), overall survival (OS) and post-progression survival (PPS) were 3.2 (95% CI : 2.63-3.80), 6.5 (95% CI : 3.78-9.35) and 2.7 months (95% CI : 1.89-3.68), respectively. PFS (r = 0.55, p < 0.01) and PPS (r = 0.89, p < 0.01) were correlated with OS. Response to second-line treatment was independently related to PFS (HR : 0.12 95%CI : 0.53-0.26, p < 0.001). Having an ECOG 0 performance status (HR : 0.42 ; 95%CI : 0.21-0.86, p = 0.02) and response to second-line therapy (HR : 0.47 ; 95%CI : 0.25-0.85, p = 0.01) were independently associated with OS.

Conclusion: PPS and PFS were correlated with OS after second-line treatment of MGC. Response to second-line treatment prolonged OS by increasing PFS, and having an ECOG 0 PS prolonged OS by increasing PPS.

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Camptothecin / analogs & derivatives
  • Camptothecin / therapeutic use
  • Capecitabine / therapeutic use
  • Cisplatin / administration & dosage
  • Disease Progression
  • Disease-Free Survival
  • Docetaxel
  • Epirubicin / administration & dosage
  • Esophagogastric Junction / pathology*
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / therapeutic use
  • Humans
  • Irinotecan
  • Leucovorin / therapeutic use
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Organoplatinum Compounds / therapeutic use
  • Peritoneal Neoplasms / drug therapy*
  • Peritoneal Neoplasms / secondary
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Survival Rate
  • Taxoids / administration & dosage
  • Taxoids / therapeutic use

Substances

  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Taxoids
  • Docetaxel
  • Epirubicin
  • Capecitabine
  • Irinotecan
  • Cisplatin
  • Leucovorin
  • Fluorouracil
  • Camptothecin

Supplementary concepts

  • Folfox protocol
  • IFL protocol