Abstract
Abstract Protein-bound polysaccharide (PSK) has been approved as an anti-cancer agent to be used in combination with chemotherapeutic drug for adjuvant therapy against gastric cancer. Several clinical studies have demonstrated that PSK has antitumor and immunomodulating properties. However, there is little evidence about the effectiveness of PSK in clinical practice. The aim of this study was to evaluate the impact of PSK on overall survival of patients with gastric cancer and predict the suitable case selection for postoperative adjuvant immunochemotherapy. The patients with stage II/III gastric cancer who underwent surgical curative resection between 2000 and 2007 at Deptarment of Surgical Oncology, Osaka City University were included in this retrospective study. All patients received oral fluorinated pyrimidine anti-metabolites with or without PSK after surgical operation. We analyzed clinicopathological features and evaluated the impact of PSK on postoperative survival rate of resectable gastric cancer. We identified 254 patients with a median follow-up of 33 months (range, 7-110 months). 138 patients received oral anti-metabolized alone (control group) and 115 patients received anti-metabolites plus PSK (PSK group). 139 patients of the cohort experienced postoperative recurrence. No significant difference between control and PSK group in overall survival or relapse free survival was detected over the 8-year period. In patients with early tumor recurrence, PSK group increased overall survival significantly (p<0.023). Among patients with pN3 lymph nodes metastasis, PSK group had better median overall survival of 28 months compared with 22 months with oral chemotherapeutics alone. After multivariate Cox regression analysis, duration of PSK administration was associated with an increased overall survival (p=0.002, HR 0.964, 95%CI 0.942 to 0.987). Our results suggested that adjuvant immunochemotherapy with PSK increased overall survival for patients with pN3 and early tumor recurrence. A population with lymph nodes metastasis might be a suitable to combine PSK with oral chemotherapeutic agents for postoperative adjuvant therapy against gastric cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1796. doi:10.1158/1538-7445.AM2011-1796
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