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KMID : 1141820220220010067
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Journal of Gastric Cancer
2022 Volume.22 No. 1 p.67 ~ p.77
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Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study
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Choi Seo-Hee
Min Jae-Seok
Jeong Sang-Ho
Yoo Moon-Won
Son Young-Gil
Oh Sung-Jin
Kim Jong-Han
Park Joong-Min
Hur Hoon
Jee Ye-Seob
Hwang Sun-Hwi
Jin Sung-Ho
Lee Sang-Eok
Lee Young-Joon
Seo Kyung-Won
Park Sung-Soo
Lee Chang-Min
Kim Chang-Hyun
Jeong In-Ho
Lee Han-Hong
Choi Sung-Il
Lee Sang-Il
Kim Chan-Young
Chae Hyun-Dong
Son Myoung-Won
Pak Kyung-Ho
Kim Sung-Soo
Lee Moon-Soo
Kim Hyoung-Il
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Abstract
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Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years.
Materials and Methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group.
Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072?3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550?5.692; P=0.001).
Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.
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KEYWORD
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Adjuvant chemotherapy, Gastric cancer, Elderly, Survival, Recurrence
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