Efficacy of Adjuvant S-1 Versus XELOX Chemotherapy for Patients with Gastric Cancer After D2 Lymph Node Dissection: A Retrospective, Multi-Center Observational Study

In Hwan Kim, Sungsoo Park, Chang Min Lee, Min Chan Kim, In Kyu Kwon, Jae Seok Min, Hyoung Il Kim, Han Hong Lee, Sang Il Lee, Hyundong Chae

Research output: Contribution to journalArticle

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Abstract

Background: After curative resection of gastric cancer with D2 lymph node dissection, postoperative adjuvant chemotherapy with S-1 or capecitabine plus oxaliplatin (XELOX) is considered to be standard therapy in Eastern countries. This study aimed to compare the efficacies of adjuvant S-1 and XELOX chemotherapy for gastric cancer patients after D2 dissection based on disease-free survival (DFS). Methods: This retrospective observational study was conducted at 29 tertiary hospitals in Korea. Of 1898 patients who underwent curative resection and received adjuvant chemotherapy for gastric cancer between February 2012 and December 2013, 1088 patients who met the eligibility criteria were enrolled in the study. After propensity score-matching, the 3-year disease-free survival rate (DFS) was used to compare efficacies directly between adjuvant XELOX and S-1 chemotherapies for patients with stage 2 or 3 gastric cancer after D2 gastrectomy. Results: The 3-year DFS rates for the S-1 and XELOX groups did not differ significantly among disease stages 2A, 2B, and 3A (all p > 0.05). However, the survival rates for the S-1 group were significantly lower than for the XELOX group for stage 3B (65.8% vs. 68.6%; p = 0.019) and stage 3C (48.4% vs. 66.7%; p = 0.002) gastric cancer. The hazard ratios (HRs) of S-1 chemotherapy for recurrence compared with XELOX for stages 3B and 3C were respectively 2.030 [95% confidence interval (CI), 1.110–3.715; p = 0.022] and 2.732 (95% CI 1.427–5.234; p = 0.002). Conclusions: Adjuvant XELOX chemotherapy was more effective than S-1 for patients with stage 3B or 3C gastric cancer after D2 lymph node dissection.

Original languageEnglish
Pages (from-to)1176-1183
Number of pages8
JournalAnnals of Surgical Oncology
Volume25
Issue number5
DOIs
Publication statusPublished - 2018 May 1

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Lymph Node Excision
Stomach Neoplasms
Observational Studies
Drug Therapy
Adjuvant Chemotherapy
Disease-Free Survival
oxaliplatin
Survival Rate
Confidence Intervals
Propensity Score
Gastrectomy
Korea
XELOX
Tertiary Care Centers
Dissection
Retrospective Studies
Recurrence

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Efficacy of Adjuvant S-1 Versus XELOX Chemotherapy for Patients with Gastric Cancer After D2 Lymph Node Dissection : A Retrospective, Multi-Center Observational Study. / Kim, In Hwan; Park, Sungsoo; Lee, Chang Min; Kim, Min Chan; Kwon, In Kyu; Min, Jae Seok; Kim, Hyoung Il; Lee, Han Hong; Lee, Sang Il; Chae, Hyundong.

In: Annals of Surgical Oncology, Vol. 25, No. 5, 01.05.2018, p. 1176-1183.

Research output: Contribution to journalArticle

Kim, In Hwan ; Park, Sungsoo ; Lee, Chang Min ; Kim, Min Chan ; Kwon, In Kyu ; Min, Jae Seok ; Kim, Hyoung Il ; Lee, Han Hong ; Lee, Sang Il ; Chae, Hyundong. / Efficacy of Adjuvant S-1 Versus XELOX Chemotherapy for Patients with Gastric Cancer After D2 Lymph Node Dissection : A Retrospective, Multi-Center Observational Study. In: Annals of Surgical Oncology. 2018 ; Vol. 25, No. 5. pp. 1176-1183.
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abstract = "Background: After curative resection of gastric cancer with D2 lymph node dissection, postoperative adjuvant chemotherapy with S-1 or capecitabine plus oxaliplatin (XELOX) is considered to be standard therapy in Eastern countries. This study aimed to compare the efficacies of adjuvant S-1 and XELOX chemotherapy for gastric cancer patients after D2 dissection based on disease-free survival (DFS). Methods: This retrospective observational study was conducted at 29 tertiary hospitals in Korea. Of 1898 patients who underwent curative resection and received adjuvant chemotherapy for gastric cancer between February 2012 and December 2013, 1088 patients who met the eligibility criteria were enrolled in the study. After propensity score-matching, the 3-year disease-free survival rate (DFS) was used to compare efficacies directly between adjuvant XELOX and S-1 chemotherapies for patients with stage 2 or 3 gastric cancer after D2 gastrectomy. Results: The 3-year DFS rates for the S-1 and XELOX groups did not differ significantly among disease stages 2A, 2B, and 3A (all p > 0.05). However, the survival rates for the S-1 group were significantly lower than for the XELOX group for stage 3B (65.8{\%} vs. 68.6{\%}; p = 0.019) and stage 3C (48.4{\%} vs. 66.7{\%}; p = 0.002) gastric cancer. The hazard ratios (HRs) of S-1 chemotherapy for recurrence compared with XELOX for stages 3B and 3C were respectively 2.030 [95{\%} confidence interval (CI), 1.110–3.715; p = 0.022] and 2.732 (95{\%} CI 1.427–5.234; p = 0.002). Conclusions: Adjuvant XELOX chemotherapy was more effective than S-1 for patients with stage 3B or 3C gastric cancer after D2 lymph node dissection.",
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T1 - Efficacy of Adjuvant S-1 Versus XELOX Chemotherapy for Patients with Gastric Cancer After D2 Lymph Node Dissection

T2 - A Retrospective, Multi-Center Observational Study

AU - Kim, In Hwan

AU - Park, Sungsoo

AU - Lee, Chang Min

AU - Kim, Min Chan

AU - Kwon, In Kyu

AU - Min, Jae Seok

AU - Kim, Hyoung Il

AU - Lee, Han Hong

AU - Lee, Sang Il

AU - Chae, Hyundong

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: After curative resection of gastric cancer with D2 lymph node dissection, postoperative adjuvant chemotherapy with S-1 or capecitabine plus oxaliplatin (XELOX) is considered to be standard therapy in Eastern countries. This study aimed to compare the efficacies of adjuvant S-1 and XELOX chemotherapy for gastric cancer patients after D2 dissection based on disease-free survival (DFS). Methods: This retrospective observational study was conducted at 29 tertiary hospitals in Korea. Of 1898 patients who underwent curative resection and received adjuvant chemotherapy for gastric cancer between February 2012 and December 2013, 1088 patients who met the eligibility criteria were enrolled in the study. After propensity score-matching, the 3-year disease-free survival rate (DFS) was used to compare efficacies directly between adjuvant XELOX and S-1 chemotherapies for patients with stage 2 or 3 gastric cancer after D2 gastrectomy. Results: The 3-year DFS rates for the S-1 and XELOX groups did not differ significantly among disease stages 2A, 2B, and 3A (all p > 0.05). However, the survival rates for the S-1 group were significantly lower than for the XELOX group for stage 3B (65.8% vs. 68.6%; p = 0.019) and stage 3C (48.4% vs. 66.7%; p = 0.002) gastric cancer. The hazard ratios (HRs) of S-1 chemotherapy for recurrence compared with XELOX for stages 3B and 3C were respectively 2.030 [95% confidence interval (CI), 1.110–3.715; p = 0.022] and 2.732 (95% CI 1.427–5.234; p = 0.002). Conclusions: Adjuvant XELOX chemotherapy was more effective than S-1 for patients with stage 3B or 3C gastric cancer after D2 lymph node dissection.

AB - Background: After curative resection of gastric cancer with D2 lymph node dissection, postoperative adjuvant chemotherapy with S-1 or capecitabine plus oxaliplatin (XELOX) is considered to be standard therapy in Eastern countries. This study aimed to compare the efficacies of adjuvant S-1 and XELOX chemotherapy for gastric cancer patients after D2 dissection based on disease-free survival (DFS). Methods: This retrospective observational study was conducted at 29 tertiary hospitals in Korea. Of 1898 patients who underwent curative resection and received adjuvant chemotherapy for gastric cancer between February 2012 and December 2013, 1088 patients who met the eligibility criteria were enrolled in the study. After propensity score-matching, the 3-year disease-free survival rate (DFS) was used to compare efficacies directly between adjuvant XELOX and S-1 chemotherapies for patients with stage 2 or 3 gastric cancer after D2 gastrectomy. Results: The 3-year DFS rates for the S-1 and XELOX groups did not differ significantly among disease stages 2A, 2B, and 3A (all p > 0.05). However, the survival rates for the S-1 group were significantly lower than for the XELOX group for stage 3B (65.8% vs. 68.6%; p = 0.019) and stage 3C (48.4% vs. 66.7%; p = 0.002) gastric cancer. The hazard ratios (HRs) of S-1 chemotherapy for recurrence compared with XELOX for stages 3B and 3C were respectively 2.030 [95% confidence interval (CI), 1.110–3.715; p = 0.022] and 2.732 (95% CI 1.427–5.234; p = 0.002). Conclusions: Adjuvant XELOX chemotherapy was more effective than S-1 for patients with stage 3B or 3C gastric cancer after D2 lymph node dissection.

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