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.

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.

• Authors: Chang Min Lee, Moon-Won Yoo, Young-Gil Son, Sung Jin Oh, Jong-Han Kim, Hyoung-Il Kim, Joong-Min Park, Hoon Hur, Ye Seob Jee, Sun-Hwi Hwang, Sung-Ho Jin, Sang Eok Lee, Ji-Ho Park, Kyung Won Seo, Sungsoo Park, Chang Hyun Kim, In Ho Jeong, Han Hong Lee, Sung Il Choi, Sang-Il Lee, Chan Young Kim, In-Hwan Kim, Myoung-Won Son, Kyung Ho Pak, Sungsoo Kim, Moon-Soo Lee, Jae-Seok Min
• Journal: Journal of gastric cancer (J Gastric Cancer) Vol. 20 Issue 2 Pg. 152-164 (Jun 2020) ISSN: 2093-582X [Print] Korea (South)
• PMID: 32595999 (Publication Type: Journal Article)
• Copyright: Copyright © 2020. Korean Gastric Cancer Association.