A trial looking at surgery with or without chemotherapy for stomach cancer

The trial team found that the results could not show that people who had chemotherapy before surgery for stomach cancer lived any longer than those who had surgery alone.

Of the 144 people recruited to take part in this trial, 138 went on to have treatment

• 69 had chemotherapy before surgery
• 69 had surgery only

Of the 69 who had chemotherapy before surgery

• 45 completed 2 cycles of chemotherapy
• 19 had only one cycle of chemotherapy
• 5 started a second cycle but did not complete it

The main reasons for not completing chemotherapy were that

• The side effects of the chemotherapy were too much for them
• Their cancer continued to grow
• Their doctor thought it best for them not to continue with the treatment

The 69 people who had chemotherapy had an endoscopy and CT scan before surgery to see how their cancer responded. When the researchers looked at these they found that in

•  4 people they could not see the cancer – a complete clinical response
• 21 people the cancer was at least half its original size – a partial clinical response

After surgery, 19 people who had chemotherapy before surgery had complications. And 11 who had only surgery had complications.

When the researchers looked at the average time people lived after surgery in both groups they felt the numbers were too small and the time of follow up too short to make a reliable assessment.

The researchers concluded that overall their trial did not show that people who had chemotherapy before surgery for stomach cancer lived longer compared to those who had surgery alone. They said that this could have been because the number of people recruited into the trial may have been too small to show a difference. Or there may be no real benefit to having chemotherapy before surgery.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.