Abstract
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. 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). 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. 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.
Highlights
Stomach cancer is one of the leading causes of cancer-related deaths in the world, especially in Eastern Asia, with 736,000 cases per year (Jemal et al, 2011)
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)
Meta-analyses indicated that patients with resectable gastric cancer could benefit from adjuvant chemotherapy (Oba, 2009; Paoletti et al, 2010)
Summary
Stomach cancer is one of the leading causes of cancer-related deaths in the world, especially in Eastern Asia, with 736,000 cases per year (Jemal et al, 2011). In order to prevent relapse and improve overall response rates, adjuvant therapies have been administered to patients with stomach cancer after radical resection, including adjuvant chemotherapy and chemoradiotherapy (Macdonald et al, 2001; Lim et al, 2005). Recent studies have shown that adjuvant chemotherapy after radical resection improves overall survival and disease-free survival of gastric cancer patients (Sakuramoto et al, 2007; Zhao et al, 2008; Paoletti et al, 2010). The study demonstrated that adjuvant chemotherapy produced a modest but statistically significant benefit associated with 5-fluorouracil based adjuvant chemotherapy after radical gastrectomy of gastric cancers (Paoletti et al, 2010). No prospective studies have been implemented to compare different adjuvant chemotherapy cycles on the prognosis of resectable stomach cancer. The purpose of this study was to retrospectively review our experience in regard to the impact of adjuvant chemotherapy cycles on the prognosis of postoperative stomach cancer
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