Experience with perioperative chemotherapy (ECC or ECF) for gastroesophageal cancer in British Columbia: A multicenter experience.

Abstract

e15153 Background: In 2006, the MAGIC trial demonstrated a significant overall survival benefit for perioperative ECF among patients with resectable gastro-esophageal cancer when compared to surgery alone. Since 2008, perioperative chemotherapy has become the standard of care for resectable gastro-esophageal cancer in our institution. We report the results of our experience with this protocol. Methods: The BC Cancer Agency is a multi-centre institution treating the majority of oncology patients for the province. A total of 83 consecutive patients with localized gastric, gastro-esophageal junction (GEJ) or lower esophageal cancer who initiated ECC/ECF perioperative chemotherapy from March 2008 to June 2011 were identified using the pharmacy database. Patient’s characteristics were abstracted to an anonymous database and analyzed. Results: In our cohort, 83 patients (66 males and 17 females) with a median age of 62 years (range 37 – 79) began preoperative chemotherapy, of whom 73 (87.9%) completed 3 cycles. The response rate was 49.3%. Among the 83 patients, 78 (93.9%) underwent surgery (2 patients died of chemotherapy toxicities, 1 refused surgery and 2 developed disease progression before surgery), of whom 11 (14.1%) could not have their tumors resected (1 unresectable, 1 with liver metastasis and 9 with peritoneal carcinomatosis). Only one patient died of surgical complications. Six patients (7.69%) achieved pathologic complete response (ypCR) and all of them are alive and recurrence-free. Forty-eight patients (57.8%) subsequently began postoperative chemotherapy, of whom 37 (44.5%) completed 3 cycles. Thirty-nine patients have died as of December 4th, 2012. The observed median survival was 38 months. Conclusions: In our multi-center experience, the results reported in the MAGIC trial were reproduced.