Folinic acid, 5-fluorouracil and etoposide after curative resection for gastric cancer.

Background/Aims: The aim of this study was to evaluate the survival benefit of adjuvant chemotherapy with etoposide, leucovorin and 5-fluorouracil (ELF) in gastric cancer patients undergoing previous surgery with a curative intent. Methodology: The clinical outcome of 49 patients with resected gastric cancer treated with adjuvant chemotherapy was compared with that of 85 surgically treated historical controls who did not receive any adjuvant treatment. The chemotherapy regimen consisted of six cycles of daily 1-hour intravenous infusions of folinic acid 100mg/m 2 and 5-FU 400mg/ m 2 , and a 2-hour infusion of etoposide 100mg/m 2 , for three days every 28 days. Results: The 5-year relapse-free survival was 32% in the adjuvant arm and 27% in the control arm (p=0.6). At the last follow-up, there were 32 deaths in the adjuvant arm and 60 in the control arm. The median duration of survival was respectively 23 and 19 months, and the 5-year survival rates were 34% and 29% (p=0.4). The chemotherapy was well tolerated. Conclusions: Our data suggest that ELF adjuvant treatment is a safe and well tolerable combination chemotherapy in patients with resected gastric cancer, but it does not seem to improve prognosis in comparison with historical controls.