title: Perioperative docetaxel, cisplatin, and 5-fluorouracil compared to standard chemotherapy for resectable gastroesophageal adenocarcinoma.
abstract: BACKGROUND
  Even though the perioperative chemotherapy improves the overall survival (OS) compared to surgery alone in patients with a resectable gastroesophageal adenocarcinoma (GEA), prognosis of these patients remains poor. Docetaxel (D), cisplatin (C), and 5-fluorouracil (F) regimen improves OS compared to CF among patients with advanced GEA. We evaluated the potential interest of a perioperative DCF regimen, compared to standard (S) regimens, in resectable GEA patients.
  
  
  METHODS
  We identified 459 patients treated with preoperative DCF or S regimens. The primary endpoint was OS. Propensity scores were estimated with a logistic regression model in which all baseline covariates were included. We then used two methods to take PS into account and thus make DCF and S patients comparable. OS analyses were performed with Kaplan-Meier and Cox models in propensity score matched samples, and inverse probability of treatment weighted (IPTW) samples.
  
  
  RESULTS
  In the propensity score matched sample, the p-value from the log rank test for OS was 0.0961, and the 3-year OS rate was 73% and 55% in DCF and S groups, respectively. The multivariate Cox regression underlined a Hazard Ratio of 0.55 (95% CI 0.27-1.13) for DCF patients compared to S patients. The results from IPTW analyses showed that DCF was significantly and independently associated with OS (HR = 0.52; 95% CI 0.40-0.69).
  
  
  CONCLUSIONS
  In this retrospective multicenter, hypothesis-generating study, the propensity score analyses underlined encouraging results in favor of DCF compared to S regimens regarding OS. This promising result should be validated in a phase-3 trial.
authors.affiliation: Department of Medical Oncology, University Hospital of Besançon, Besançon, France; Clinical Investigational Center, CIC-1431, University Hospital of Besançon, France; INSERM, Unit 1098, University of Franche-Comté, Besançon, France. Electronic address: chkim@chu-besancon.fr.
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.affiliation: Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.
authors.forename: S
authors.initials: S
authors.lastname: Paget-Bailly
authors.affiliation: Lille University Hospital, Department of Digestive Surgery, Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Messager
authors.affiliation: Department of Medical Oncology, University Hospital of Besançon, Besançon, France.
authors.forename: T
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, University Hospital of Besançon, Besançon, France.
authors.forename: P
authors.initials: P
authors.lastname: Mathieu
authors.affiliation: Department of Surgery, Nord Franche Comté Hospital, Montbéliard, France.
authors.forename: N
authors.initials: N
authors.lastname: Lamfichekh
authors.affiliation: Department of Gastroenterology, University Hospital of Besançon, Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Fein
authors.affiliation: Department of Gastroenterology, Nord Franche Comté Hospital, Belfort, France.
authors.forename: S
authors.initials: S
authors.lastname: Fratté
authors.affiliation: Department of Gastroenterology, Hospital of Vesoul, Vesoul, France.
authors.forename: D
authors.initials: D
authors.lastname: Cléau
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, University Hospital of Besançon, Besançon, France.
authors.forename: Z
authors.initials: Z
authors.lastname: Lakkis
authors.affiliation: Department of Medical Oncology, University Hospital of Besançon, Besançon, France; INSERM, Unit 1098, University of Franche-Comté, Besançon, France.
authors.forename: M
authors.initials: M
authors.lastname: Jary
authors.affiliation: Department of Oncology and Radiotherapy, Nord Franche Comté Hospital, Montbéliard, France.
authors.forename: N
authors.initials: N
authors.lastname: Sakek
authors.affiliation: Clinical Investigational Center, CIC-1431, University Hospital of Besançon, France.
authors.forename: M
authors.initials: M
authors.lastname: Jacquin
authors.affiliation: Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.
authors.forename: A
authors.initials: A
authors.lastname: Foubert
authors.affiliation: Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France; EA 3181, University of Franche-Comté, Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Bonnetain
authors.affiliation: Lille University Hospital, Department of Digestive Surgery, Lille, France; FREGAT, French Esophageal and Gastric Tumor Working Group, France.
authors.forename: C
authors.initials: C
authors.lastname: Mariette
authors.affiliation: Department of Medical Oncology, University Hospital of Besançon, Besançon, France; Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Fiteni
authors.affiliation: Department of Medical Oncology, University Hospital of Besançon, Besançon, France; Clinical Investigational Center, CIC-1431, University Hospital of Besançon, France; INSERM, Unit 1098, University of Franche-Comté, Besançon, France.
authors.forename: C
authors.initials: C
authors.lastname: Borg
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil
keywords: Docetaxel; Gastric cancer; Gastroesophageal cancer; Neoadjuvant; Preoperative; Taxane