Volume 29, Issue 155, January 2025

The effectiveness of surgical treatment with perioperative therapy compared to surgery alone in the treatment of gastric cancer - a systematic review

Michał Muciek^1♦, Jakub Kawka², Alicja Baranowska³, Katarzyna Baranowska², Filip Czyżewski², Kinga Filipek⁴, Sebastian Mrugała⁵, Waldemar Mrugała¹, Bartosz Skierkowski¹, Natalia Zalewska⁶

¹Medical Univeristy of Lublin, al. Racławickie 1, 20-059 Lublin, Poland
²Medical University of Warsaw, ul. Zwirki i Wigury 61, 02-091 Warsaw, Poland
³Szpital Miejski w Siemanowicach Śląskich, Poland
⁴Miedzyleski Specialist Hospital in Warsaw, Poland
⁵Medical University of Białystok, Jana Kilińskiego 1, 15-089 Białystok, Poland
⁶Bielański Hospital, Warsaw, Poland

^♦Corresponding Author
Medical Univeristy of Lublin, al. Racławickie 1, 20-059 Lublin, Poland

ABSTRACT

Introduction: Gastric cancer poses a significant challenge for physicians. This cancer is a growing concern globally due to its rising occurrence and high mortality rate. The standard approach to treatment has been surgery, but it often falls short of delivering effective outcomes. Combining surgery with perioperative chemotherapy could offer a promising alternative. In this article, we will analyze clinical studies comparing the aforementioned treatment methods. Methodology: We analyzed four independent clinical studies comparing surgery alone to surgery with perioperative chemotherapy. The total number of patients included in these studies was 2,841, who were randomly assigned to either the surgery-only group or the perioperative chemotherapy group (1,403 and 1,438 patients, respectively). Results and discussion: The overall five-year survival rate was 35 percent in the surgery-only group and 46.75 percent in the perioperative chemotherapy group. The five-year recurrence-free survival rate was 30 percent for the surgery-only group and 44 percent for the perioperative chemotherapy group. This indicates that perioperative chemotherapy increased overall survival by 33 percent and increased the proportion of patients with a five-year recurrence-free period by 46 percent. The clinical studies we reviewed clearly demonstrated the superiority of combining surgery with perioperative chemotherapy compared to surgery alone. Every effort should be made to refine chemotherapy or find alternative methods to support oncological surgery.

Keywords: Gastric Cancer, Surgery, Chemotherapy

Medical Science, 2025, 29, e3ms3471

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DOI: https://doi.org/10.54905/disssi.v29i155.e3ms3471

Published: 09 January 2025