Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Long-term Efficacy of S-1 Monotherapy or Capecitabine Plus Oxaliplatin as Adjuvant Chemotherapy for Patients with Stage II or III Gastric Cancer after Curative Gastrectomy: a Propensity Score-Matched Multicenter Cohort Study

  • Lee, Chang Min (Department of Surgery, Korea University College of Medicine) ;
  • Yoo, Moon-Won (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Son, Young-Gil (Department of Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine) ;
  • Oh, Sung Jin (Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Kim, Jong-Han (Department of Surgery, Korea University College of Medicine) ;
  • Kim, Hyoung-Il (Department of Surgery, Yonsei University College of Medicine) ;
  • Park, Joong-Min (Department of Surgery, Chung-Ang University College of Medicine) ;
  • Hur, Hoon (Department of Surgery, Ajou University School of Medicine) ;
  • Jee, Ye Seob (Department of Surgery, Dankook University Hospital) ;
  • Hwang, Sun-Hwi (Department of Surgery, Pusan National University Yangsan Hospital) ;
  • Jin, Sung-Ho (Department of Surgery, Korea Cancer Center Hospital) ;
  • Lee, Sang Eok (Department of Surgery, Konyang University Hospital) ;
  • Park, Ji-Ho (Department of Surgery, Gyeongsang National University Hospital) ;
  • Seo, Kyung Won (Department of Surgery, Kosin University College of Medicine) ;
  • Park, Sungsoo (Department of Surgery, Korea University College of Medicine) ;
  • Kim, Chang Hyun (Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jeong, In Ho (Department of Surgery, Jeju National University Hospital) ;
  • Lee, Han Hong (Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Choi, Sung Il (Department of Surgery, Kyung Hee University Hospital at Gangdong) ;
  • Lee, Sang-Il (Department of Surgery, Chungnam National University College of Medicine) ;
  • Kim, Chan Young (Department of Surgery, Chonbuk National University College of Medicine) ;
  • Kim, In-Hwan (Department of Surgery, Daegu Catholic University College of Medicine) ;
  • Son, Myoung-Won (Department of Surgery, Soonchunhyang University Cheonan Hospital) ;
  • Pak, Kyung Ho (Department of Surgery, Hallym University Dongtan Sacred Heart Hospital) ;
  • Kim, Sungsoo (Department of Surgery, Jeju National University Hospital) ;
  • Lee, Moon-Soo (Department of Surgery, Eulji University Hospital) ;
  • Min, Jae-Seok (Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Cancer Center)
  • Received : 2019.12.19
  • Accepted : 2020.03.11
  • Published : 2020.06.30
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Abstract

Purpose: To compare long-term disease-free survival (DFS) between patients receiving tegafur/gimeracil/oteracil (S-1) or capecitabine plus oxaliplatin (CAPOX) adjuvant chemotherapy (AC) for gastric cancer (GC). Materials and Methods: This retrospective multicenter observational study enrolled 983 patients who underwent curative gastrectomy with consecutive AC with S-1 or CAPOX for stage II or III GC at 27 hospitals in Korea between February 2012 and December 2013. We conducted propensity score matching to reduce selection bias. Long-term oncologic outcomes, including DFS rate over 5 years (over-5yr DFS), were analyzed postoperatively. Results: The median and longest follow-up period were 59.0 and 87.6 months, respectively. DFS rate did not differ between patients who received S-1 and CAPOX for pathologic stage II (P=0.677) and stage III (P=0.899) GC. Moreover, hazard ratio (HR) for recurrence did not differ significantly between S-1 and CAPOX (reference) in stage II (HR, 1.846; 95% confidence interval [CI], 0.693-4.919; P=0.220) and stage III (HR, 0.942; 95% CI, 0.664-1.337; P=0.738) GC. After adjustment for significance in multivariate analysis, pT (4 vs. 1) (HR, 11.667; 95% CI, 1.595-85.351; P=0.016), pN stage (0 vs. 3) (HR, 2.788; 95% CI, 1.502-5.174; P=0.001), and completion of planned chemotherapy (HR, 2.213; 95% CI, 1.618-3.028; P<0.001) were determined as independent prognostic factors for DFS. Conclusions: S-1 and CAPOX AC regimens did not show significant difference in over-5yr DFS after curative gastrectomy in patients with stage II or III GC. The pT, pN stage, and completion of planned chemotherapy were prognostic factors for GC recurrence.

Keywords

References

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