The association between the duration of fluoropyrimidine-based adjuvant chemotherapy and survival in stage II or III gastric cancer.

Seong-Geun Kim,Sun-Hwi Hwang

doi:10.1186/s12957-016-0845-1

Abstract

BackgroundThis study was conducted to propose the optimal duration of fluoropyrimidine-based adjuvant chemotherapy consisting of fluoropyrimidine derivatives alone or combined with intravenous platinum for stage II or III gastric cancer (GC).MethodsWe analyzed retrospectively the data from 2219 patients with histologically confirmed adenocarcinoma in the stomach, who underwent a curative gastrectomy with lymphadenectomy from 2005 to 2012. Five-year overall survival (OS) and 3-year relapse-free survival (RFS) were analyzed according to the duration of fluoropyrimidine-based adjuvant chemotherapy.ResultsData from 617 patients with stage II or III GC were analyzable; 187 patients (30.3 %) were treated with surgery alone, while 430 patients (69.7 %) were treated with postoperative adjuvant chemotherapy. The duration of adjuvant chemotherapy was less than 6 months [group 1] in 147 patients (34.2 %), 6 months to less than 12 months [group 2] in 94 patients (21.9 %), 1 year to less than 2 years [group 3] in 139 patients (32.3 %), and over 2 years [group 4] in 50 patients (11.6 %). The 5-year OS in groups 1, 2, 3, and 4 was 75.7, 87, 90.3, and 93.4 %, respectively, while 3-year RFS was 52.5, 58.8, 81.4, and 94.0 %, respectively.ConclusionsIn this retrospective study, we did not demonstrate any significant improvement in OS and RFS by longer periods of fluoropyrimidine-based adjuvant chemotherapy in stage II or III GCs. Further prospective randomized studies are needed.

Highlights

This study was conducted to propose the optimal duration of fluoropyrimidine-based adjuvant chemotherapy consisting of fluoropyrimidine derivatives alone or combined with intravenous platinum for stage II or III gastric cancer (GC)
Statistical methods The primary analysis involved evaluating the association between the duration of chemotherapy and overall survival (OS), which was defined from the time of surgery to death or the last
The 3-year relapse-free survival (RFS) rate for the adjuvant chemotherapy group was 69.3 % compared to 73.9 % in the surgery-only group

Summary

Introduction

This study was conducted to propose the optimal duration of fluoropyrimidine-based adjuvant chemotherapy consisting of fluoropyrimidine derivatives alone or combined with intravenous platinum for stage II or III gastric cancer (GC). According to the estimated incidence, mortality and worldwide prevalence data for 2012 from the International Agency for Research on Cancer, gastric cancer (GC) is the fifth most common malignancy in the world. With nearly 1 million cases per annum, it is the third leading cause of cancer-related death in both sexes worldwide [1]. GC is the second most common malignancy in Asia and more than half of. For the treatment of gastric and gastroesophageal junction adenocarcinoma, the Intergroup trial 0116 (INT0116) in 2001 showed the first high-level evidence for improved survival from adjuvant therapy in GC [7].

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