Abstract
BackgroundThis study compared the long-term efficacy of different durations of adjuvant chemotherapy for patients with gastric cancer after radical gastrectomy with D2 lymphadenectomy.MethodsWe retrospectively identified 428 patients with stage II–III gastric cancer who underwent D2 gastrectomy between 2009 and 2016. Patients were divided into four groups according to the duration of adjuvant chemotherapy, including 0 week (no adjuvant, group A), 20 to 24 weeks (completed 7–8 cycles every 3 weeks or 10–12 cycles every 2 weeks, group B), and 12 to18 weeks (completed 4–6 cycles every 3 weeks or 6–9 cycles every 2 weeks, group C), and less than 12 weeks (received up to 3 cycles every 3 weeks or 5 cycles every 2 weeks, group D). The chemotherapy regimens included XELOX, SOX, and FOLFOX. 5-year overall survival (OS) and disease-free survival (DFS) were analyzed.ResultsThe 5-year OS rates for groups A, B, C, and D were 52.3, 73.7, 72.0, and 53.3%, respectively, and the 5-year DFS rates were 50.0, 68.0, 65.4, and 50.0%, respectively. OS and DFS were higher in group B than in groups A and D. Similarly, patients in group C were more likely to have higher OS and DFS than those in groups A and D. Meanwhile, there were no significant differences in OS and DFS between groups B and C. The multivariate analysis confirmed with high statistical significance the efficacy of complete courses of adjuvant chemotherapy, and, among them, the similar impact of 4–6/6–9 and 7–8/10–12 cycles, resulting in similar HRs vs Group A (0.52 and 0.42, respectively).ConclusionsTo reduce toxicity and maintain efficacy, XELOX or SOX chemotherapy regimens administered for 4–6 cycles every 3 weeks or FOLFOX regimen for 6–9 cycles every 2 weeks might be a favorable option for patients with stage II–III gastric cancer after D2 gastrectomy. Prospective multicenter clinical trials with adequate sample sizes are necessary to verify these findings.
Highlights
This study compared the long-term efficacy of different durations of adjuvant chemotherapy for patients with gastric cancer after radical gastrectomy with D2 lymphadenectomy
To reduce toxicity and maintain efficacy, Capecitabine and oxaliplatin (XELOX) or S-1 and oxaliplatin (SOX) chemotherapy regimens administered for 4– 6 cycles every 3 weeks or FOLFOX regimen for 6–9 cycles every 2 weeks might be a favorable option for patients with stage II–III gastric cancer after D2 gastrectomy
The inclusion criteria were as follows: (1) age, 18–79 years; (2) no obvious surgical contraindications identified in a preoperative multidisciplinary evaluation, such as severe heart or lung disease; (3) prior completion of radical gastrectomy with D2 lymphadenectomy and a postoperative pathological diagnosis of stage II–III gastric cancer; (4) no receipt of adjuvant chemotherapy or receipt of only doublet chemotherapy (XELOX, SOX, or FOLFOX) after surgery; and (5) started adjuvant chemotherapy within 3 months after surgery
Summary
This study compared the long-term efficacy of different durations of adjuvant chemotherapy for patients with gastric cancer after radical gastrectomy with D2 lymphadenectomy. Gastric cancer (GC) is one of the most common malignancies in humans, ranking fifth in incidence and third in mortality globally. Eastern Asia has the highest incidence and mortality rates of GC in the world, and the disease is mainly concentrated in Korea, China, and Japan [1]. In China, the overall incidence of GC is declining, it remains the second deadliest malignancy after lung cancer and the third leading cause of mortality [2]. Unlike the situation in Japan and Korea, more than 80% of patients with GC in China are diagnosed with locally advanced disease, which carries higher risks of postoperative recurrence and metastasis. Postoperative adjuvant chemotherapy is the main treatment [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
