Long-term efficacy of s-1 monotherapy or capecitabine plus oxaliplatin as adjuvant chemotherapy for patients with stage ii or iii gastric cancer after curative gastrectomy: A propensity score-matched multicenter cohort study

Chang Min Lee, Moon Won Yoo, Young Gil Son, Sung Jin Oh, Jong Han Kim, Hyoung Il Kim, Joong Min Park, Hoon Hur, Ye Seob Jee, Sun Hwi Hwang, Sung Ho Jin, Sang Eok Lee, Ji Ho Park, Kyung Won Seo, Sungsoo Park, Chang Hyun Kim, In Ho Jeong, Han Hong Lee, Sung Il Choi, Sang Il LeeChan Young Kim, In Hwan Kim, Myoung Won Son, Kyung Ho Pak, Sungsoo Kim, Moon Soo Lee, Jae Seok Min

Research output: Contribution to journalArticle

Abstract

Purpose: To compare long-term disease-free survival (DFS) between patients receiving tegafur/gimeracil/oteracil (S-1) or capecitabine plus oxaliplatin (CAPOX) adjuvant chemotherapy (AC) for gastric cancer (GC). Materials and Methods: This retrospective multicenter observational study enrolled 983 patients who underwent curative gastrectomy with consecutive AC with S-1 or CAPOX for stage II or III GC at 27 hospitals in Korea between February 2012 and December 2013. We conducted propensity score matching to reduce selection bias. Long-term oncologic outcomes, including DFS rate over 5 years (over-5yr DFS), were analyzed postoperatively. Results: The median and longest follow-up period were 59.0 and 87.6 months, respectively. DFS rate did not differ between patients who received S-1 and CAPOX for pathologic stage II (P=0.677) and stage III (P=0.899) GC. Moreover, hazard ratio (HR) for recurrence did not differ significantly between S-1 and CAPOX (reference) in stage II (HR, 1.846; 95% confidence interval [CI], 0.693–4.919; P=0.220) and stage III (HR, 0.942; 95% CI, 0.664–1.337; P=0.738) GC. After adjustment for significance in multivariate analysis, pT (4 vs. 1) (HR, 11.667; 95% CI, 1.595–85.351; P=0.016), pN stage (0 vs. 3) (HR, 2.788; 95% CI, 1.502–5.174; P=0.001), and completion of planned chemotherapy (HR, 2.213; 95% CI, 1.618–3.028; P<0.001) were determined as independent prognostic factors for DFS. Conclusions: S-1 and CAPOX AC regimens did not show significant difference in over-5yr DFS after curative gastrectomy in patients with stage II or III GC. The pT, pN stage, and completion of planned chemotherapy were prognostic factors for GC recurrence.

Original languageEnglish
Pages (from-to)152-164
Number of pages13
JournalJournal of Gastric Cancer
Volume20
Issue number2
DOIs
Publication statusPublished - 2020 Jun

Keywords

  • Adjuvant chemotherapy
  • Disease-free survival
  • Gastric cancer

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

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    Lee, C. M., Yoo, M. W., Son, Y. G., Oh, S. J., Kim, J. H., Kim, H. I., Park, J. M., Hur, H., Jee, Y. S., Hwang, S. H., Jin, S. H., Lee, S. E., Park, J. H., Seo, K. W., Park, S., Kim, C. H., Jeong, I. H., Lee, H. H., Choi, S. I., ... Min, J. S. (2020). Long-term efficacy of s-1 monotherapy or capecitabine plus oxaliplatin as adjuvant chemotherapy for patients with stage ii or iii gastric cancer after curative gastrectomy: A propensity score-matched multicenter cohort study. Journal of Gastric Cancer, 20(2), 152-164. https://doi.org/10.5230/jgc.2020.20.e13