The following is a summary of “Short- and long-term outcomes after perioperative EOX therapy versus upfront surgery for gastric cancer: a single-centre propensity score–matched cohort study,” published in the April 2025 issue of BMC Surgery by Back et al. 

Researchers conducted a retrospective study to compare short- and long-term survival outcomes between upfront surgery (US) and surgery combined with perioperative EOX (epirubicin, oxaliplatin, capecitabine) therapy in gastric cancer (GC).  

They analysed 310 patients who underwent curative intent gastrectomy for GC at a single tertiary centre between 2006 and 2017. Patients were assigned to the EOX group (n=105) or the US group (n=205). Propensity score matching (PSM) was used to balance baseline characteristics, clinical stage, surgery type, and histology. Short-term outcomes included the Comprehensive Complication Index (CCI) and 30-day mortality, while long-term outcomes included overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS).  

The results showed that after PSM, 102 patients remained in each group. The EOX group had significantly lower preoperative hemoglobin levels compared to the US group, though other baseline characteristics were similar. Tumor-related outcomes favored the EOX group, with significantly smaller tumors (P<0.001), fewer metastatic lymph nodes (P=0.004), and lower tumor stages. Splenectomy was more common in the US group (40.2% vs 23.5%, P=0.011). Postoperative complications were similar, but ICU admissions were more frequent in the EOX group (16.7% vs 6.9%, P=0.030) and 30-day mortality rates were low and comparable (1.0% in the EOX group vs 2.0% in the US group, P=1.000). Long-term outcomes, including OS, DSS, and DFS, showed no significant differences between the groups.  

Investigators concluded that perioperative EOX therapy was as safe as US and significantly reduced metastatic lymph nodes and tumor size, suggesting its role in downstaging the disease, but that despite these promising oncological responses, this benefit had not translated into improved long-term survival. 

Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-025-02919-4