Abstract
4022 Background: Standard adjuvant therapy for curatively resected has not been established in Japan. To evaluate the efficacy of oral fluorinated pyrimidine over surgery alone control, a meta-analysis was performed after investigating 14 clinical trials for gastric cancer. Methods: Fourteen randomized trials comparing oral fluorinated pyrimidine and surgery alone after curative resection for gastric cancer was evaluated. Trials with improper randomization using envelop method or trials with low quality control were meticulously examined and excluded from the analysis. A total of 1047 patients, enrolled in three relevant trials (JCOG 8401, JCOG 8801, and JCOG 9206–1)mostly using UFT for the treatment arm using central randomization were defined eligible for the meta-analysis. The endpoint was overall survival and analysis on intent to treat basis was implemented. Results: The 5 year overall survival odds ratio was 0.66(95% CI; 0.48–0.91) The treatment effect of oral fluorinated pytimidine was shown to be statistically significant (p=0.011). The results of this meta-analysis suggest that chemotherapy after surgery with oral fluorinated pyrimidines (mainly UFT) can improve the survival of patients with curatively reected gastric cancer and could be one of the standard adjuvant chemotherapies for locally advanced gastric cancer in Japan. No significant financial relationships to disclose.
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