Impact of upfront randomization for postoperative treatment on quality of surgery in the CRITICS gastric cancer trial

Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
Y H M ClaassenCornelis J H van de Velde

Abstract

Preoperative randomization for postoperative treatment might affect quality of surgery. In the CRITICS trial (ChemoRadiotherapy after Induction chemotherapy In Cancer of the Stomach), patients were randomized before treatment to receive chemotherapy prior to a D1 + gastrectomy (removal of lymph node station (LNS) 1-9 + 11), followed by either chemotherapy (CT) or chemoradiotherapy (CRT). In this analysis, the influence of upfront randomization on the quality of surgery was evaluated. Quality of surgery was analyzed in both study arms using surgicopathological compliance (removal of ≥ 15 lymph nodes), surgical compliance (removal of the indicated LNS), and surgical contamination (removal of LNS that should be left in situ). Furthermore, the 'Maruyama Index of Unresected disease' (MI) was evaluated in both study arms, and validated with overall survival. Between 2007 and 2015, 788 patients with gastric cancer were included in the CRITICS study of which 636 patients were operated with curative intent. No difference was observed between the CT and CRT group regarding surgicopathological compliance (74.8% vs 70.9%, P = 0.324), surgical compliance (43.2% vs 39.2%, P = 0.381), and surgical contamination (59.4% vs 59.9%, P = 0.567). Me...Continue Reading

References

Mar 30, 2002·Annals of Surgical Oncology·Scott A HundahlUNKNOWN Southwest Oncology Group and the Gastric Intergroup
Dec 1, 2005·World Journal of Surgery·K C M J PeetersC J H van de Velde
Jul 11, 2006·The New England Journal of Medicine·David Cunningham MAGIC Trial Participants
Jun 20, 2007·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Scott A HundahlCornelis J H van de Velde
Mar 25, 2010·BMJ : British Medical Journal·Kenneth F SchulzUNKNOWN CONSORT Group
Mar 30, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Marc YchouPhilippe Rougier
Mar 15, 2016·World Journal of Gastroenterology : WJG·Maurizio DegiuliMario Morino
Aug 18, 2017·Annals of Surgery·Yvette H M ClaassenCornelis J H van de Velde

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Citations

Apr 10, 2019·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Erik van WerkhovenPatrick M Bossuyt

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Methods Mentioned

BETA
dissection
pancreatectomies
surgical resection

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