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http://dx.doi.org/10.7314/APJCP.2013.14.1.381

Impact of Adjuvant Chemotherapy Cycles on Prognosis of Resectable Stomach Cancer: A Retrospective Analysis  

Zhang, Wen-Ying (Department of Gastroenterology, Changhai Hospital, Second Military Medical University)
Zhang, Wen-Jun (Department of Gerontology, Changhai Hospital, Second Military Medical University)
Bai, Yu (Department of Gastroenterology, Changhai Hospital, Second Military Medical University)
Yuan, Hai-Hua (Department of Oncology, No. 3 People's Hospital, School of Medicine, Shanghai Jiaotong University)
Liu, Feng (Department of Oncology, No. 3 People's Hospital, School of Medicine, Shanghai Jiaotong University)
Gao, Jun (Department of Gastroenterology, Changhai Hospital, Second Military Medical University)
Gong, Yan-Fang (Department of Gastroenterology, Changhai Hospital, Second Military Medical University)
Jiang, Bin (Department of Oncology, No. 3 People's Hospital, School of Medicine, Shanghai Jiaotong University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.14, no.1, 2013 , pp. 381-386 More about this Journal
Abstract
Aims: The aim of this study was to investigate the effects of adjuvant chemotherapy cycles on the prognosis of patients with post-operative stomach cancer through retrospective analysis. Methods: A total of 128 patients with gastric cancer who underwent gastrectomy, followed by adjuvant chemotherapy consisting of epirubicin, cisplatin or oxaliplatin, leucovorin, and 5-fluorouracil, according to a defined schedule, were divided into three groups according to the number of chemotherapy cycles: Group I (<6 cycles); Group II (6 cycles); and Group III (>6 cycles). Results: The 5-year overall survival (OS) was 20.8% in Group I, 45.0% in Group II, and 42.9% in Group III, with a median follow-up of 43 months. The 5-year relapse-free survival (RFS) was 15.1% in Group I, 40% in Group II, and 40% in Group III. The OS and RFS in Groups II and III were significantly better than in Group I (OS, p = 0.002 and p=0.003; RFS, P<0.001 and P=0.002). There was no difference in OS (p = 0.970) or in RFS (p = 0.722) between Groups II and III. Multivariate Cox hazard analysis determined that the number of adjuvant chemotherapy cycles was an independent factor that influenced OS and RFS. Conclusion: Six cycles of adjuvant chemotherapy gave encouraging outcomes in patients with resectable gastric cancer. Further prospective randomized controlled investigations are warranted in a multi-center setting.
Keywords
Adjuvant chemotherapy; stomach cancer; gastrectomy;
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1 Neri B, Pantaleo P, Giommoni E, et al (2007). Oxaliplatin, 5-fluorouracil/leucovorin and epirubicin as first-line treatment in advanced gastric carcinoma: a phase II study. Br J Cancer, 96, 1043-6.   DOI   ScienceOn
2 Oba K (2009). Efficacy of adjuvant chemotherapy using tegafur-based regimen for curatively resected gastric cancer: update of a meta-analysis. Int J Clin Oncol, 14, 85-9.   DOI
3 Oh SC (2012). Update of adjuvant chemotherapy for resected gastric cancer. J Gastric Cancer, 12, 3-6.   DOI   ScienceOn
4 Oken MM, Creech RH, Tormey DC, et al (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol, 5, 649-55.   DOI   ScienceOn
5 Okines A, Verheij M, Allum W, et al (2010). Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 21, v50-4.   DOI   ScienceOn
6 Panzini I, Gianni L, Fattori PP, et al (2002). Adjuvant chemotherapy in gastric cancer: a meta-analysis of randomized trials and a comparison with previous meta-analyses. Tumori, 88, 21-7.
7 Paoletti X, Oba K, Burzykowski T, et al (2010). Benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis. JAMA, 303, 1729-37.   DOI   ScienceOn
8 Sakuramoto S, Sasako M, Yamaguchi T, et al (2007). Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med, 357, 1810-20.   DOI   ScienceOn
9 Saletti P, Berthold D, Ghielmini M, et al (2007). Adjuvant chemotherapy (ECF regimen) for patients with gastric adenocarcinoma. Hepatogastroenterology, 54, 969-72.
10 Sasako M, Sakuramoto S, Katai H, et al (2011). Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol, 29, 4387-93.   DOI   ScienceOn
11 Zhang CX, Huang S, Xu N, et al (2007). Phase II study of epirubicin plus oxaliplatin and infusional 5-fluorouracil as first-line combination therapy in patients with metastatic or advanced gastric cancer. Anticancer Drugs, 18, 581-6.   DOI   ScienceOn
12 Zhao SL, Fang JY (2008). The role of postoperative adjuvant chemotherapy following curative resection for gastric cancer: a meta-analysis. Cancer Invest, 26, 317-25.   DOI   ScienceOn
13 Bang YJ, Kim YW, Yang HK, et al (2012). Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet, 379, 315-21.   DOI   ScienceOn
14 Cunningham D, Allum WH, Stenning SP, et al (2006). Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med, 355, 11-20.   DOI   ScienceOn
15 Cunningham D, Starling N, Rao S, et al (2008). Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med, 358, 36-46.   DOI   ScienceOn
16 Degiuli M, Calvo F (2006). Survival of early gastric cancer in a specialized European center. Which lymphadenectomy is necessary? World J Surg, 30, 2193-203.   DOI
17 De Vita F, Giuliani F, Orditura M, et al (2007). Adjuvant chemotherapy with epirubicin, leucovorin, 5-fluorouracil and etoposide regimen in resected gastric cancer patients: a randomized phase III trial by the Gruppo Oncologico Italia Meridionale (GOIM 9602 Study). Ann Oncol, 18, 1354-8.   DOI   ScienceOn
18 Jeen YT, Yoon SY, Shin SW, et al (2001). Phase II trial of epirubicin, cisplatin, oral uracil and tegafur, and leucovorin in patients with advanced gastric carcinoma. Cancer, 91, 2288-93.   DOI   ScienceOn
19 Di Costanzo F, Gasperoni S, Manzione L, et al (2008). Adjuvant chemotherapy in completely resected gastric cancer: a randomized phase III trial conducted by GOIRC. J Natl Cancer Inst, 100, 388-98.   DOI   ScienceOn
20 Dikken JL, Jansen EP, Cats A, et al (2010). Impact of the extent of surgery and postoperative chemoradiotherapy on recurrence patterns in gastric cancer. J Clin Oncol, 28, 2430-6.   DOI   ScienceOn
21 Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.   DOI
22 Kang BW, Kim JG, Chae YS, et al (2011). Pilot study of adjuvant chemotherapy with 3-week combination of S-1 and cisplatin for patients with stage II-IV (M0) gastric cancer. Invest New Drugs, 30, 1671-5.
23 Karacetin D, Incekara O (2004). A randomized trial of 5-fluorouracil, leucovorin, cisplatin and epirubicin (PELF) versus 5-fluorouracil, leucovorin and etoposide (ELF) given as adjuvant chemotherapy to patients with resected advanced gastric adenocarcinomas. J BUON, 9, 263-7.
24 Kim DH, Oh CA, Oh SJ, et al (2012). Validation of seventh edition AJCC gastric cancer staging modifications. J Surg Oncol, 105, 26-30.   DOI   ScienceOn
25 Kulig J, Kolodziejczyk P, Sierzega M, et al (2010). Adjuvant chemotherapy with etoposide, adriamycin and cisplatin compared with surgery alone in the treatment of gastric cancer: a phase III randomized, multicenter, clinical trial. Oncology, 78, 54-61.   DOI   ScienceOn
26 Lim L, Michael M, Mann GB, et al (2005). Adjuvant therapy in gastric cancer. J Clin Oncol, 23, 6220-32.   DOI   ScienceOn
27 Aoyama T, Yoshikawa T, Watanabe T, et al (2011). Survival and prognosticators of gastric cancer that recurs after adjuvant chemotherapy with S-1. Gastric Cancer, 14, 150-4.   DOI
28 Moon YW, Jeung HC, Rha SY, et al (2007). Changing patterns of prognosticators during 15-year follow-up of advanced gastric cancer after radical gastrectomy and adjuvant chemotherapy: a 15-year follow-up study at a single korean institute. Ann Surg Oncol, 14, 2730-7.   DOI