title: Effect of adjuvant chemoradiotherapy on overall survival of gastric cancer patients submitted to D2 lymphadenectomy.
abstract: BACKGROUND
  Adjuvant chemoradiotherapy (CRT) is the standard treatment in Western countries for gastric cancer patients submitted to curative resection. However, the role of adjuvant CRT in gastric cancer treated with D2 lymphadenectomy has not been well defined.
  
  
  METHODS
  We conducted a retrospective study in patients with stage II to IV gastric adenocarcinoma with no distant metastases, who underwent curative resection with D2 lymphadenectomy between January 2002 and December 2007. The present study compared the 3-year overall survival of two treatments (adjuvant CRT according to the INT 0116 trial versus resection alone). Survival curves were estimated by the Kaplan-Meier method and compared with a log-rank test. Multivariate analysis of prognostic factors was performed by the Cox proportional hazards model.
  
  
  RESULTS
  A total of 185 patients were included, 104 patients (56 %) received adjuvant CRT and 81 received resection alone. The 3-year overall survival was 64.4 % in the CRT group and 61.7 % in the resection-alone group (p: 0.415). However, according to the Cox proportional hazards model, adjuvant CRT was a prognostic factor for 3-year overall survival (hazard ratio [HR] 0.46, 95 % confidence interval [CI] 0.26-0.82, p: 0.008).
  
  
  CONCLUSIONS
  In the present study, adjuvant CRT was associated with a lower risk of death over a 3-year period in gastric cancer patients treated with D2 lymphadenectomy.
authors: Department of Gastrointestinal Medical Oncology, Barretos Cancer Hospital, Str Antenor Duarte Villela 1331, Barretos, SP, 14784-400, Brazil. jacome@usp.br
authors: Alexandre A A
authors: AA
authors: Jácome
authors: Durval R
authors: DR
authors: Wohnrath
authors: Cristovam
authors: C
authors: Scapulatempo Neto
authors: José Humberto T G
authors: JH
authors: Fregnani
authors: Ana Luiza
authors: AL
authors: Quinto
authors: Antônio T T
authors: AT
authors: Oliveira
authors: Vinícius L
authors: VL
authors: Vazquez
authors: Gilberto
authors: G
authors: Fava
authors: Edson Z
authors: EZ
authors: Martinez
authors: José S
authors: JS
authors: Santos
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome