American journal of clinical oncology
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Am. J. Clin. Oncol. · Jun 1999
Clinical TrialAdjuvant (cisplatin, etoposide, and 5-fluorouracil) chemotherapy after curative resection of gastric adenocarcinomas involving the esophagogastric junction.
Gastric adenocarcinomas involving the esophagogastric junction represent a particular therapeutic problem because they lie in the border area between two body cavities: the thorax and the abdomen. The prognosis of gastric adenocarcinomas involving esophagogastric junction is poor because there is widespread lymphatic metastasis, making curative resection difficult. Even in patients with localized disease who are potentially curable, the 5-year survival rate is approximately 20% with curative resection only, somewhat lower than for those with cancer elsewhere in the stomach. ⋯ The toxicities of PEF adjuvant chemotherapy were leukopenia, nausea/vomiting, and alopecia, but they were mostly mild and reversible except in one patient who died because of treatment-related sepsis. Adjuvant chemotherapy with three cycles of PEF regimen was well tolerated and seems to be a promising treatment for gastric adenocarcinoma involving the esophagopstric junction, in comparison with previous treatments. To define the efficacy of adjuvant PEF chemotherapy for gastric adenocarcinoma involving esophagogastric junction, prospective randomized trials are warranted.
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Am. J. Clin. Oncol. · Jun 1999
Bulky, barrel-shaped cervical carcinoma (stages IB, IIA, IIB): the prognostic factors for pelvic control and treatment outcome.
The purpose of this study was to assess the prognostic factors for pelvic control and the treatment outcome in bulky, barrel-shaped cervical carcinomas. Between September 1980 and December 1992, 65 patients with stage IB or stage IIA-B carcinoma of the uterine cervix classified as barrel-shaped or concentrically expanded (i.e., at least 5 cm in greatest diameter) were treated with curative intent. Forty patients had stage IB or stage IIA carcinoma (according to the classification of the International Federation of Gynecology and Obstetrics [FIGO]), and 25 patients had FIGO stage IIB carcinoma. ⋯ However, for patients with tumors that respond poorly to external beam radiotherapy, local control and survival are poor. More aggressive treatment protocols should be considered for these patients. The routine use of adjuvant hysterectomy is not recommended.