title: Adjuvant treatments for gastric cancer: from practice guidelines to clinical practice.
abstract: BACKGROUND
  For gastric cancers, the benefits of adjuvant radiochemotherapy and of perioperative chemotherapy have been demonstrated since 2001 and 2006 respectively. The aim of this study was to evaluate the diffusion of adjuvant treatments in a French population.
  
  
  METHODS
  334 incident gastric cancers UICC Stage IB, II, III or IVM0 resected for cure and recorded in the Burgundy digestive cancer registry were retrospectively included. Patients were classified as having received an effective adjuvant treatment if they had been treated by adjuvant radiochemotherapy since 2001 or perioperative chemotherapy since 2006.
  
  
  RESULTS
  The proportion of patients treated with an effective adjuvant treatment increased from 21.8% (2001-2005) to 40.1% (2006-2009). Patients treated in 2006-2009 were twice as likely to receive effective adjuvant treatment as those treated during the period 2001-2005. During the 2004-2009 period, 62.4% of cases were presented in a multidisciplinary team meeting. These patients were almost three times more likely to receive effective adjuvant treatment than patients excluded from multidisciplinary team consultation. Age was a significant factor, independent of comorbidities.
  
  
  CONCLUSIONS
  Administration of adjuvant treatment is still far from being considered a reference regimen in routine practice for R0 resected gastric cancer. The increase in multidisciplinary team meetings should improve the situation.
authors: University Hospital Dijon; Digestive Cancer Registry of Burgundy; Inserm U866; University of Burgundy, Dijon, F-21079, France. Electronic address: anne-marie.bouvier@u-bourgogne.fr.
authors: Anne Marie
authors: AM
authors: Bouvier
authors: Radiotherapy Department, Centre Georges-François Leclerc, Dijon, France.
authors: Gilles
authors: G
authors: Créhange
authors: Radiotherapy Department, Centre Georges-François Leclerc, Dijon, France.
authors: Caroline
authors: C
authors: Azélie
authors: University Hospital Dijon; Digestive Cancer Registry of Burgundy; Inserm U866; University of Burgundy, Dijon, F-21079, France.
authors: Nicolas
authors: N
authors: Cheynel
authors: University Hospital Dijon; Digestive Cancer Registry of Burgundy; Inserm U866; University of Burgundy, Dijon, F-21079, France.
authors: Jean Louis
authors: JL
authors: Jouve
authors: University Hospital Dijon; Digestive Cancer Registry of Burgundy; Inserm U866; University of Burgundy, Dijon, F-21079, France.
authors: Laurent
authors: L
authors: Bedenne
authors: University Hospital Dijon; Digestive Cancer Registry of Burgundy; Inserm U866; University of Burgundy, Dijon, F-21079, France.
authors: Jean
authors: J
authors: Faivre
authors: University Hospital Dijon; Digestive Cancer Registry of Burgundy; Inserm U866; University of Burgundy, Dijon, F-21079, France.
authors: Côme
authors: C
authors: Lepage
authors: Radiotherapy Department, Centre Georges-François Leclerc, Dijon, France.
authors: Philippe
authors: P
authors: Maingon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000706:statistics & numerical data*; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D012042:Registries; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000628:therapy*; D016896:Treatment Outcome
keywords: Adjuvant treatment; Cancer registry; Chemoradiation; Gastric carcinoma; Radiation therapy