In the MAGIC trial (Medical Research Council Adjuvant Gastric Infusional Chemotherapy), perioperative chemotherapy with ECF regimen significantly improved which outcome in resectable gastric and lower esophageal cancer?
- A Pathological complete response rate was significantly improved
- B R0 resection rate was significantly improved but survival benefit was marginal
- C 5-year overall survival improved from 23% to 36% ✓
- D Disease-free survival improved but not overall survival
Correct answer: C. 5-year overall survival improved from 23% to 36%
Explanation
The MAGIC trial demonstrated that perioperative ECF chemotherapy (epirubicin, cisplatin, fluorouracil — 3 cycles pre-op and 3 post-op) significantly improved 5-year overall survival from 23% (surgery alone) to 36% (perioperative chemotherapy), and also improved progression-free survival and R0 resection rates. This established perioperative chemotherapy as the standard of care for resectable gastric and lower EGJ adenocarcinoma in Europe. Pathological complete response rates with ECF are low (typically <10%).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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