Mangoane phutholla kobo (Stretch out the blanket, Aunt)

"Aunt, stretch out the blanket. There are two of us. Stretch out the blanket, I will be coming, I am going out to smoke. When I leave here, going away. Montsala remain here and look after my children. Look after Mamotolo and Malerato and Toma. Toma, look after these children of mine particulary Mamotolo and Malerato. I looks as if I will be going away. I feel I am going. I really feel I will be crossing the river." 'To cross the river' in Sesotho means "I will be going to the Union of South Africa" with reference to the Calendon river which forms part of the border between the two countries. Women's party song, with clapping

209: ROLE OF ADJUVANT CHEMOTHERAPY IN LOW BURDEN (YPT0-T1N0) GASTRIC ADENOCARCINOMA AFTER NEOADJUVANT CHEMOTHERAPY

Abstract Background and aim Since 2006, perioperative chemotherapy(periCT) has become an established treatment for patients with resectable gastric adenocarcinoma in Europe after the demonstration of a survival benefit in two randomized clinical trials. However, only half of patients included in the periCT arm started adjuvant chemotherapy(adjCT), suggesting a preponderant effect of neoadjuvant chemotherapy(neoCT) on the survival benefit observed. The aim of this study was to assess the benefit of adjCT on disease-free survival in patients with low tumor burden(LTB) (ypT0N0 or ypT1N0) after neoCT. Methods Data were collected from 30 European centres from 2007 to 2017. Among 2131 included patients, 762 patients received neoCT and 135 had LTB (17.7%), including 40 patients (5.3%) with complete pathological response. Among patients with LTB, 85 (63%) received adjCT(adjCT+) and 50 patients (37%) did not (adjCT-). Propensity score matching analyses were used to compensate for differences in baseline characteristics between ajdCT+ and adjCT- patients. Results NeoCT regimen was mainly based on platinum-fluoropyrimidine doublet or triplet regimen(88.1%). In univariate analysis, predictive factors for LTB after neoCT were antro-pyloric location, pretherapeutic stage≤cT2, well-differentiated tumor, ≥2 cycles of preoperative chemotherapy, intestinal or mixt-type according to Lauren’s classification and non poorly-cohesive cells tumor. Patients in adjCT- group were older and had more frequently severe postoperative complications (≥ grade 3a according to Dindo-Clavien’s classification) than patients in adjCT+ group. Despite this, 5-years overall(OS) and disease-free survival(DFS) rates were comparable between adjCT+ and adjcCT- groups, respectively 92% vs. 82% and 89% vs.83%. After propensity score analysis, OS and DFS remain comparable between adjCT+ and adjCT- groups. In adjCT+ group, patients received mostly the same chemotherapy as that received preoperatively (82%). However, severe toxicity was described in 11 patients (13%). Among patients with ypT0N0 response with a follow-up longer than 3 months, 4 patients experienced tumor recurrence or death (11.4%). All of these patients had received adjuvant chemotherapy. Conclusion Performing adjCT in patients with LTB after neoCT does not seem to provide any benefit on OS or DFS, with non-negligible toxicity rates in counterpart. </jats:sec