@article{JGO27109,
author = {Nicholas A. Bradley and Christina Wilson and Janet Graham and Jeff Evans and Grant Fullarton and Colin K. Mackay and Carol Craig and David McIntosh and Andrew MacDonald and Derek Grose and Matthew Forshaw},
title = {The downstaging approach to irresectable oesophageal and gastric cancer: a single centre experience},
journal = {Journal of Gastrointestinal Oncology},
volume = {10},
number = {3},
year = {2019},
keywords = {},
abstract = {Background: There is uncertainty over optimal management of locally advanced non-metastatic oesophageal and gastric (OG) adenocarcinomas which are deemed irresectable at time of diagnosis due to local tumour or nodal burden. Current practice in our regional centre is to administer chemotherapy in a “downstaging” strategy in the hope of achieving tumour shrinkage to allow radical treatment. Patients without sufficient response to downstaging are treated palliatively. The aim of this study was to review our single unit outcomes of this treatment strategy.
Methods: Data was collected retrospectively from electronic patient records on all cases discussed at regional MDT over a 32-month period (January 2015–August 2017).
Results: A total of 44 patients [70.5% male, median age 70 years, 13 (29.5%) oesophageal, 12 (27.3%) junctional and 19 (43.2%) gastric] were included in the study. Thirty-six (81.8%) of patients received the full number of planned cycles of chemotherapy; toxicity and disease progression (both 6.8% of cases) were the most common reasons for early cessation of treatment. Seventeen (38.6%) patients underwent resection and an R0 resection was achieved in 13 (76.5%) of these patients. After median follow up of 16.8 months, the median overall survival (OS) in the resection vs. palliative cohorts was 42.6 vs. 16.4 months (P},
issn = {2219-679X}, url = {https://jgo.amegroups.org/article/view/27109}
}