13 results on '"Labianca, R"'
Search Results
2. Consensus and controversies regarding follow-up after treatment with curative intent of nonmetastatic colorectal cancer: a synopsis of guidelines used in countries represented in the European Society of Coloproctology.
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Bastiaenen VP, Hovdenak Jakobsen I, Labianca R, Martling A, Morton DG, Primrose JN, Tanis PJ, and Laurberg S
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- Consensus, Europe, Humans, Societies, Medical, Aftercare standards, Colorectal Neoplasms therapy, Colorectal Surgery standards, Practice Guidelines as Topic
- Abstract
Aim: It is common clinical practice to follow patients for a period of years after treatment with curative intent of nonmetastatic colorectal cancer, but follow-up strategies vary widely. The aim of this systematic review was to provide an overview of recommendations on this topic in guidelines from member countries of the European Society of Coloproctology, with supporting evidence., Method: A systematic search of Medline, Embase and the guideline databases Trip database, BMJ Best Practice and Guidelines International Network was performed. Quality assessment included use of the AGREE-II tool. All topics with recommendations from included guidelines were identified and categorized. For each subtopic, a conclusion was made followed by the degree of consensus and the highest level of evidence., Results: Twenty-one guidelines were included. The majority recommended that structured follow-up should be offered, except for patients in whom treatment of recurrence would be inappropriate. It was generally agreed that clinical visits, measurement of carcinoembryoinc antigen and liver imaging should be part of follow-up, based on a high level of evidence, although the frequency is controversial. There was also consensus on imaging of the chest and pelvis in rectal cancer, as well as endoscopy, based on lower levels of evidence and with a level of intensity that was contradictory., Conclusion: In available guidelines, multimodal follow-up after treatment with curative intent of colorectal cancer is widely recommended, but the exact content and intensity are highly controversial. International agreement on the optimal follow-up schedule is unlikely to be achieved on current evidence, and further research should refocus on individualized 'patient-driven' follow-up and new biomarkers., (Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.)
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- 2019
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3. Addressing the challenges of pancreatic cancer: future directions for improving outcomes.
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Hidalgo M, Cascinu S, Kleeff J, Labianca R, Löhr JM, Neoptolemos J, Real FX, Van Laethem JL, and Heinemann V
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- Combined Modality Therapy, Early Detection of Cancer, Europe, Humans, Palliative Care, Prognosis, Survival Rate, Carcinoma, Pancreatic Ductal diagnosis, Carcinoma, Pancreatic Ductal mortality, Carcinoma, Pancreatic Ductal therapy, Pancreatic Neoplasms diagnosis, Pancreatic Neoplasms mortality, Pancreatic Neoplasms therapy
- Abstract
Pancreatic ductal adenocarcinoma (PDAC), which accounts for more than 90% of all pancreatic tumours, is a devastating malignancy with an extremely poor prognosis, as shown by a 1-year survival rate of around 18% for all stages of the disease. The low survival rates associated with PDAC primarily reflect the fact that tumours progress rapidly with few specific symptoms and are thus at an advanced stage at diagnosis in most patients. As a result, there is an urgent need to develop accurate markers of pre-invasive pancreatic neoplasms in order to facilitate prediction of cancer risk and to help diagnose the disease at an earlier stage. However, screening for early diagnosis of prostate cancer remains challenging and identifying a highly accurate, low-cost screening test for early PDAC for use in clinical practice remains an important unmet need. More effective therapies are also crucial in PDAC, since progress in identifying novel therapies has been hampered by the genetic complexity of the disease and treatment remains a major challenge. Presently, the greatest step towards improved treatment efficacy has been made in the field of palliative chemotherapy by introducing FOLFIRINOX (folinic acid, 5-fluorouracil, irinotecan and oxaliplatin) and gemcitabine/nab-paclitaxel. Strategies designed to raise the profile of PDAC in research and clinical practice are a further requirement in order to ensure the best treatment for patients. This article proposes a number of approaches that may help to accelerate progress in treating patients with PDAC, which, in turn, may be expected to improve the quality of life and survival for those suffering from this devastating disease., (Copyright © 2014. Published by Elsevier B.V.)
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- 2015
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4. Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.
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Labianca R, Nordlinger B, Beretta GD, Mosconi S, Mandalà M, Cervantes A, and Arnold D
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- Antineoplastic Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Capecitabine, Carcinoembryonic Antigen blood, Chemotherapy, Adjuvant, Chromosome Deletion, Chromosome Disorders genetics, Chromosomes, Human, Pair 18 genetics, Colonic Neoplasms epidemiology, Colonoscopy, Deoxycytidine analogs & derivatives, Deoxycytidine therapeutic use, Europe epidemiology, Female, Fluorouracil analogs & derivatives, Fluorouracil therapeutic use, Follow-Up Studies, Humans, Intestinal Mucosa pathology, Leucovorin therapeutic use, Lymphatic Metastasis, Male, Neoplasm Recurrence, Local therapy, Neoplasm Staging, Occult Blood, Organoplatinum Compounds therapeutic use, Oxaloacetates, Risk, Risk Assessment, Risk Factors, Sigmoidoscopy, Treatment Outcome, Colonic Neoplasms diagnosis, Colonic Neoplasms therapy, Early Detection of Cancer
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- 2013
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5. Body mass index at diagnosis and survival among colon cancer patients enrolled in clinical trials of adjuvant chemotherapy.
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Sinicrope FA, Foster NR, Yothers G, Benson A, Seitz JF, Labianca R, Goldberg RM, Degramont A, O'Connell MJ, and Sargent DJ
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- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chemotherapy, Adjuvant, Colonic Neoplasms diagnosis, Colonic Neoplasms pathology, Europe epidemiology, Female, Fluorouracil administration & dosage, Humans, Male, Neoplasm Staging, North America epidemiology, Overweight epidemiology, Prognosis, Randomized Controlled Trials as Topic, Risk Factors, Survival Analysis, Thinness epidemiology, Body Mass Index, Colonic Neoplasms drug therapy, Colonic Neoplasms mortality
- Abstract
Background: Although obesity is an established risk factor for developing colon cancer, its prognostic impact and relation to patient sex in colon cancer survivors remains unclear., Methods: The authors examined the prognostic and predictive impact of the body mass index (BMI) in patients with stage II and III colon carcinoma (N = 25,291) within the Adjuvant Colon Cancer Endpoints (ACCENT) database. BMI was measured at enrollment in randomized trials of 5-fluorouracil-based adjuvant chemotherapy. Association of BMI with the time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS) were determined using Cox regression models. Statistical tests were 2-sided., Results: During a median follow-up of 7.8 years, obese and underweight patients had significantly poorer survival compared with overweight and normal-weight patients. In a multivariable analysis, the adverse prognostic impact of BMI was observed among men but not among women (Pinteraction = .0129). Men with class 2 and 3 obesity (BMI ≥ 35.0 kg/m(2) ) had a statistically significant reduction in DFS (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.01-1.33; P = .0297) compared with normal-weight patients. Underweight patients had a significantly shorter TTR and reduced DFS (HR, 1.18; 95% CI, 1.09-1.28; P < .0001) that was more significant among men (HR, 1.31; 95% CI, 1.15-1.50; P < .0001) than among women (HR, 1.11; 95% CI, 1.01-1.23; P = .0362; Pinteraction = .0340). BMI was not predictive of a benefit from adjuvant treatment., Conclusions: Obesity and underweight status were associated independently with inferior outcomes in patients with colon cancer who received treatment in adjuvant chemotherapy trials., (Copyright © 2013 American Cancer Society.)
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- 2013
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6. The management of chronic pain in important patient subgroups.
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Cherubino P, Sarzi-Puttini P, Zuccaro SM, and Labianca R
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- Activities of Daily Living, Aged, Analgesics, Opioid adverse effects, Anxiety epidemiology, Anxiety etiology, Chronic Pain etiology, Depression epidemiology, Depression etiology, Europe, Humans, Neoplasms complications, Neoplasms therapy, Quality of Life, Analgesics therapeutic use, Analgesics, Opioid therapeutic use, Chronic Pain drug therapy
- Abstract
Chronic pain is a major healthcare issue in Europe and globally, and inadequate or undertreated pain significantly reduces the ability of many patients to participate in ordinary daily activities, adversely affects their employment status and contributes to a substantial rate of depression and anxiety in patients with chronic pain. There is a broad distinction of chronic pain into chronic non-cancer pain and chronic cancer pain, and important subgroups of these include patients with rheumatic and/or orthopaedic diseases, pain syndromes caused by cancer itself and caused by cancer treatment. Despite comprising the majority of non-cancer pain in Europe, chronic non-cancer pain associated with rheumatic diseases and/or orthopaedic conditions is often inadequately managed. Although paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) play a continuing role in the treatment of chronic rheumatic diseases, accumulating evidence of potential toxicity with both traditional non-selective NSAIDs and selective cyclooxygenase 2 inhibitors has prompted a reassessment of their use. This has particular resonance for the elderly, who are more likely to have significant pain issues than younger patients and are at high risk of NSAID-related adverse events. The use of mild opioids, such as codeine and tramadol, and strong opioids, such as morphine, hydromorphone and oxycodone, may be appropriate where paracetamol and other non-opioid analgesics are ineffective in chronic non-cancer pain. Cancer pain, either related to the underlying disease or caused by cancer treatment, is also a common cause of chronic pain in the elderly. An understanding of individual needs is essential in providing adequate pain relief, which is a central goal of care in all patients with chronic pain.
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- 2012
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7. Primary colon cancer: ESMO Clinical Practice Guidelines for diagnosis, adjuvant treatment and follow-up.
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Labianca R, Nordlinger B, Beretta GD, Brouquet A, and Cervantes A
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- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoembryonic Antigen blood, Chemotherapy, Adjuvant, Colonic Neoplasms pathology, Colonoscopy, Early Detection of Cancer, Europe epidemiology, Follow-Up Studies, Humans, Incidence, Meta-Analysis as Topic, Neoplasm Staging, Prognosis, Randomized Controlled Trials as Topic, Risk Factors, Secondary Prevention, Survival Analysis, Treatment Outcome, Colonic Neoplasms diagnosis, Colonic Neoplasms therapy
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- 2010
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8. Venous thromboembolism (VTE) in cancer patients. ESMO clinical recommendations for prevention and management.
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Mandalà M and Labianca R
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- Anticoagulants therapeutic use, Europe, Health Planning Guidelines, Humans, Risk Factors, Societies, Medical, Venous Thromboembolism drug therapy, Venous Thromboembolism epidemiology, Neoplasms complications, Venous Thromboembolism prevention & control, Venous Thromboembolism therapy
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- 2010
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9. Adjuvant treatment of colorectal cancer at the turn of the century: European and US perspectives.
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Wils J, O'Dwyer P, and Labianca R
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- Antimetabolites, Antineoplastic administration & dosage, Chemotherapy, Adjuvant, Clinical Trials as Topic, Colorectal Neoplasms radiotherapy, Colorectal Neoplasms surgery, Drug Administration Schedule, Europe, Fluorouracil administration & dosage, Humans, International Cooperation, Leucovorin administration & dosage, Practice Patterns, Physicians', Radiotherapy, Adjuvant, United States, Antimetabolites, Antineoplastic therapeutic use, Colorectal Neoplasms drug therapy, Fluorouracil therapeutic use
- Abstract
Background: Despite early scepticism, several studies of systemic adjuvant 5-fluorouracil (5-FU)-based chemotherapy demonstrated significant benefits in high-risk colon cancer. As many clinical investigations have since been conducted in this setting, a comprehensive literature review was undertaken to clarify the role of adjuvant therapy in the treatment of colorectal cancer., Design: Current and future adjuvant treatment approaches in colorectal cancer were reviewed, and differences in the present-day North American and European practices were highlighted., Results and Conclusions: 5-FU plus leucovorin for six months is generally considered the 'standard' adjuvant treatment in Dukes' stage C (stage II) colon cancer. Large-scale international trials of other strategies are required to provide further advances in treatment outcome. Following the lead of the USA Intergroup trials, a recently initiated cooperative effort, the Pan-European Trials in Adjuvant Colon Cancer (PETACC), may serve as a European model for such investigations. In T3 and/or lymph-node positive rectal cancer, postoperative (chemo)radiotherapy in the USA is considered the adjuvant treatment of choice. However, most European investigators have advocated for preoperative intensive short-course irradiation instead. Randomized trials in this area are ongoing. In the near future, new drugs for the treatment of colorectal cancer may lead to tailored therapies.
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- 2001
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10. A multinational study to measure the value that patients with cancer place on improved emesis control following cisplatin chemotherapy.
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Dranitsaris G, Leung P, Ciotti R, Ortega A, Spinthouri M, Liaropoulos L, Labianca R, and Quadri A
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- Antiemetics therapeutic use, Antineoplastic Agents therapeutic use, Attitude to Health, Canada, Cisplatin therapeutic use, Europe, Female, Humans, Income, Male, Middle Aged, Vomiting chemically induced, Antiemetics economics, Antineoplastic Agents adverse effects, Cisplatin adverse effects, Neoplasms drug therapy, Quality of Life, Vomiting prevention & control
- Abstract
Background: The neurokinin-1 (NK1) receptor antagonists are a new class of agents designed to reduce the risk of emesis following chemotherapy, particularly with cisplatin. Early data from double-blind randomised trials suggest that an orally administered NK1 antagonist can reduce the absolute risk of acute and delayed emesis following cisplatin by 20 and 30%, respectively., Objective: To measure the value that patients with cancer place on improved emesis control and quality of life., Design: Willingness-to-pay analysis., Setting: Five study sites in Canada, Italy, Spain and Greece., Patients and Participants: 245 patients with cancer either receiving chemotherapy with cisplatin or who had received cisplatin-based chemotherapy within the previous 6 months., Methods: After background information had been presented, patients were asked to define the maximum that they would pay per day for a drug that reduced their risk of acute and delayed (days 2 to 5) emesis by 20 and 30%, respectively. Costs were converted to US dollars ($US) using year 2000 exchange rates., Results: For a 20% improvement in acute emesis, Canadian, Italian and Spanish patients with cancer were willing to pay $US46, $US34 and $US63 per day, respectively, compared with $US8 for patients from Greece (p < 0.001). For a 30% improvement in delayed emesis, Canadian, Italian and Spanish patients with cancer were also willing to pay more than their Greek counterparts (SUS41, $US31, $US50 and $US9 daily for 4 days, respectively; p < 0.001). These significant differences in patient value between countries remained, even after adjusting for socioeconomic variables and previous history of emesis., Conclusions: There are substantial cultural differences in how patients with cancer value benefit and improved quality of life. Since the majority of the world's population resides outside North America and Western Europe, there may be a need to re-evaluate perceived levels of patient benefit and measures of quality of life.
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- 2001
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11. Evaluation of clinical efficacy of new medical treatments in advanced colorectal cancer. Results of a workshop organized by the EORTC GITCCG. European Organization for Research and Treatment of Cancer. Gastrointestinal Tract Cancer Cooperative Group.
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Wils J, Sahmoud T, Sobrero A, Bleiberg H, Ahmedzai S, Blazeby J, Blijham G, Conroy T, Cunningham D, Curran D, Díaz-Rubio E, Ducreux M, Evans J, Glimelius B, Hutchinson G, Kerr D, Kiebert G, Köhne H, Labianca R, Langendijk R, Nitti D, Nordlinger B, Rougier P, Scheithauer W, and Therasse P
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- Clinical Trials as Topic, Colorectal Neoplasms drug therapy, Colorectal Neoplasms pathology, Education, Europe, Humans, Predictive Value of Tests, Prognosis, Treatment Outcome, Colorectal Neoplasms therapy
- Abstract
During the last few years several factors have contributed to an increasing change in the medical treatment of advanced colorectal cancer. Among them are the more general acceptance of the impact of chemotherapy on quality of life and survival in first as well as in second-line treatment, the introduction of new drugs and the definition of novel endpoints which can roughly be defined as "patient benefit". For this reason the European Organization for Research and Treatment of Cancer (EORTC) Gastrointestinal Tract Cancer Cooperative Group (GITCCG) felt it was appropriate to organize a workshop with experts from different countries and national groups to discuss in depth several aspects concerning the treatment of patients with advanced colorectal cancer.
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- 1998
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12. Gastrointestinal Tract Cancer Liaison Office: an attempt to organise clinical research in Europe.
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Bleiberg H, Gerard B, Wils J, Blijham G, Diaz-Rubio E, Herrmann R, Kerr D, Labianca R, Rougier P, Wilke HJ, and Wilking N
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- Colorectal Neoplasms therapy, Cooperative Behavior, Esophageal Neoplasms therapy, Europe, Humans, Interinstitutional Relations, Pancreatic Neoplasms therapy, Stomach Neoplasms therapy, Controlled Clinical Trials as Topic, Gastrointestinal Neoplasms therapy, Multicenter Studies as Topic
- Abstract
The Gastrointestinal Tract Cancer Liaison Office (GITCLO) was developed in an attempt to organise the increasing body of clinical research in gastrointestinal tumours in Europe. This paper represents an analysis, by tumour localisation, of the trials collected for the second edition of the GITCLO booklet. The list of cooperative groups, chairmen and study coordinators is given with their respective telephone and telefax numbers. A total of 84 trials were collected, conducted by 46 co-operative groups in 14 countries. For each organ and stage of disease, a summary of concepts investigated is given with the references of the study co-ordinator. Obviously, too many questions are raised at the same time. In colorectal cancer, for example, a total of 41 trials exploring 22 concepts are currently open for patients' registration. We hope that the present attempt to clarify the situation of clinical research in the field of gastrointestinal cancers in Europe will speed up therapeutic progress in the best interest of the patients.
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- 1997
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13. Final results of a phase III clinical trial of adjuvant chemotherapy with the modified fluorouracil, doxorubicin, and mitomycin regimen in resectable gastric cancer.
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Lise M, Nitti D, Marchet A, Sahmoud T, Buyse M, Duez N, Fiorentino M, Dos Santos JG, Labianca R, and Rougier P
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- Adenocarcinoma drug therapy, Adenocarcinoma mortality, Adenocarcinoma surgery, Chemotherapy, Adjuvant, Combined Modality Therapy, Disease-Free Survival, Doxorubicin administration & dosage, Europe, Female, Fluorouracil administration & dosage, Humans, Male, Mitomycin administration & dosage, Proportional Hazards Models, Stomach Neoplasms mortality, Stomach Neoplasms surgery, Survival Rate, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Stomach Neoplasms drug therapy
- Abstract
Purpose: In a randomized clinical trial (European Organization for the Research and Treatment of Cancer [EORTC] no. 40813) on adjuvant chemotherapy in gastric cancer, results obtained after administration of the FAM2 regimen (fluorouracil [5-FU], doxorubicin, and mitomycin) were compared with results obtained after surgery alone to assess the effect of this regimen on overall survival, time to progression, and disease-free interval., Patients and Methods: Three hundred fourteen patients who had undergone curative resection for stage II or stage III (International Union Against Cancer [UICC] 1978) gastric adenocarcinoma were randomized to receive chemotherapy (treatment arm) or no further treatment (control arm). The chemotherapy schedule was repeated every 43 days for seven cycles. The log-rank test and the Cox model were used for statistical analysis., Results: Of 314 patients, 159 comprised the control group and 155 the FAM2 group. Nineteen FAM2 patients never received chemotherapy. The median number of cycles was five. Of the patients started on adjuvant treatment, severe hematologic and nonhematologic toxicity (grades 3 or 4, World Health Organization [WHO] scale) occurred, respectively, in 6% to 9% and in 1% to 29% of cases. The overall 5-year survival rate was 70% for stage II and 32% for stage III patients. No statistically significant difference was found between overall survival of the two treatment arms (P = .295). However, time to progression was significantly delayed in the FAM2 arm (P = .020) and disease-free survival showed borderline significance (P = .068)., Conclusion: FAM2, in view of its high toxicity, cannot be advocated as standard adjuvant treatment for gastric cancer. Large-scale clinical trials using more active, less toxic regimens are required to demonstrate whether adjuvant chemotherapy provides any real benefit.
- Published
- 1995
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