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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

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Author(s)
Hyoung-Il KimJong-Han KimJoong-Min ParkHoon HurYe Seob JeeSun-Hwi HwangSung-Ho JinSang Eok LeeJi-Ho ParkKyung Won SeoSungsoo ParkChang Hyun KimChang Min LeeMoon-Won YooYoung-Gil SonSung Jin OhIn Ho JeongHan Hong LeeSung Il ChoiSang-Il LeeChan Young KimIn-Hwan KimMyoung-Won SonKyung Ho PakSungsoo KimMoon-Soo LeeJae-Seok Min
Publication Year
2020
Keyword
Gastric cancerAdjuvant chemotherapyDisease-free survival
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.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine (의과대학)
Citation
Journal of Gastric Cancer, Vol.20(2) : 152-164, 2020
Type
Article
ISSN
2093-5641
DOI
10.5230/jgc.2020.20.e13
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/42757
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