AUTHOR=Kumar Sunil , Kumar Naveen , Deo Suryanarayana , Bhoriwal Sandeep , Mandal Amitabha , Sharma Atul , Pathy Sushmita , Das Prasenjit , Thulkar Sanjay , Bhatnagar Sushma 

TITLE=Patterns of Multimodality Management of Gastric Cancer—Single Institutional Experience of 372 Cases From a Tertiary Care Center in North India

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.877493

DOI=10.3389/fonc.2022.877493

ISSN=2234-943X

ABSTRACT=Introduction:
Worldwide gastric cancer is the 5th most commonly diagnosed cancer and the leading cause of gastrointestinal cancer-related deaths. Alone surgery provides long term survival improvements in 20% of the patients with local advanced gastric cancer.  The results can be improved considering multimodal management including chemotherapy and radiotherapy. However, in low middle-income countries like India, multimodal management is challenging. Herein, we evaluated the experience of multimodal management of gastric cancer and the long term outcome. 
Methods: 
Retrospective analysis of the data of 372 patients was done from a prospectively maintained computerized database from 1994 to 2021.  Records were analysed for demographic details, treatment patterns, recurrences and long term outcomes(DFS &OS). Statistical analysis was one with packages SPSS version 26 (IBM Corp, Chicago, Illinois, USA). 
Results:
This study included 372 patients. The mean age of the patients was 54.07. Total 307 patients (82.5%) cases were operated upfront, 45(12%) received NACT and 20(5.5%) of cases underwent the palliative procedure. A total of 53.2% underwent curative resection. . R0 resection rate was achieved in 95% of patients. 72.58% of patients required adjuvant treatment and the majority of the patients underwent chemoradiotherapy. The most common site of metastasis was the liver. The Median follow up was 50.16 months. The 3-year disease-free and overall survivals were 36.28% & 67.8% and the 5-year disease-free and overall survivals were 30.15% & 37.7% respectively.
Conclusion: 
Our study suggested that multimodal management is required in locally advanced gastric cancer to achieve good long-term outcomes. The treatment sequence can be tailored based on the available resources