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KMID : 1141820200200020152
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Journal of Gastric Cancer
2020 Volume.20 No. 2 p.152 ~ p.164
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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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Lee Chang-Min
Yoo Moon-Won
Son Young-Gil
Oh Sung-Jin
Kim Jong-Han
Kim Hyoung-Il
Park Joong-Min
Hur Hoon
Jee Ye-Seob
Hwang Sun-Hwi
Jin Sung-Ho
Lee Sang-Eok
Park Ji-Ho
Seo Kyung-Won
Park Sung-Soo
Kim Chang-Hyun
Jeong In-Ho
Lee Han-Hong
Choi Sung-Il
Lee Sang-Il
Kim Chan-Young
Kim In-Hwan
Son Myoung-Won
Pak Kyung-Ho
Kim Sung-Soo
Lee Moon-Soo
Min Jae-Seok
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Abstract
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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.
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KEYWORD
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Gastric cancer, Adjuvant chemotherapy, Disease-free survival
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