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http://dx.doi.org/10.5230/jgc.2019.19.e15

Albumin-Bilirubin Score Predicts Tolerability to Adjuvant S-1 Monotherapy after Curative Gastrectomy  

Miwa, Takashi (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Kanda, Mitsuro (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Tanaka, Chie (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Kobayashi, Daisuke (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Hayashi, Masamichi (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Yamada, Suguru (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Nakayama, Goro (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Koike, Masahiko (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Kodera, Yasuhiro (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
Publication Information
Journal of Gastric Cancer / v.19, no.2, 2019 , pp. 183-192 More about this Journal
Abstract
Purpose: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. Materials and Methods: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. Results: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08-20.1; cutoff value, -2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69-7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33-45.8; P=0.002). Conclusions: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.
Keywords
Gastric cancer; S-1; Adjuvant chemotherapy; Biomarker; Albumin-bilirubin score;
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