MAGIC versus MacDonald treatment regimens for gastric cancer: Trends and predictors of multimodal therapy for gastric cancer using the National Cancer Database

Mark Jayanathan, Ryan P Erwin, Nicholas Molacek, Marcus Fluck, Marie Hunsinger, Jeffrey Wild, Tania K Arora, Mohsen M Shabahang, Jan Franko, Joseph A Blansfield

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

BACKGROUND: Multimodal therapy is beneficial in gastric cancer, however this practice is not universal. This study examines trends, identifies associative factors, and examines overall survival (OS) benefit from multimodal therapy in gastric cancer.

METHODS: Gastric cancer patients staged IB-III from 2005 to 2014, identified using the National Cancer Database, were categorized by treatment: surgery alone, perioperative chemotherapy, and adjuvant chemoradiation. Groups were analyzed to identify associative factors of perioperative therapy.

RESULTS: We examined 9243 patients, with the majority receiving multimodal therapy (57%). The proportion of those receiving perioperative chemotherapy rose dramatically from 7.5% in 2006 to 46% in 2013. Academic center treatment was strongly associated with perioperative over adjuvant therapy (p < 0.0001). An OS advantage was clearly seen in those receiving multimodal therapy versus surgery alone (p < 0.0001), with no difference between perioperative and adjuvant therapies.

CONCLUSIONS: Treatment of gastric cancer with multimodal therapy has risen significantly since 2005, largely due to increasing use of perioperative chemotherapy. As perioperative therapy becomes more prevalent, more patients will have the opportunity for the improved survival benefit of multimodal therapy.

Original languageEnglish (US)
Pages (from-to)129-135
Number of pages7
JournalAmerican Journal of Surgery
Volume219
Issue number1
DOIs
StatePublished - Jan 2020
Externally publishedYes

Keywords

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents/therapeutic use
  • Chemoradiotherapy, Adjuvant
  • Combined Modality Therapy/trends
  • Databases, Factual
  • Female
  • Gastrectomy
  • Humans
  • Male
  • Middle Aged
  • Preoperative Period
  • Retrospective Studies
  • Stomach Neoplasms/mortality
  • Survival Rate
  • Young Adult

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