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

민재석; 이창민; 유문원; 손영길; Sung Jin Oh; Jong-Han Kim; 김형일; 박중민; 허훈; 지예섭; 황순휘; 진성호; 이상억; 박지호; 서경원; 박성수; 김찬영; In-Hwan Kim; 손명원; 박경호; Sungsoo Kim; Moon-Soo Lee

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자료유형: 학술저널

저자정보: 민재석 이창민 유문원 손영길 Sung Jin Oh Jong-Han Kim 김형일 박중민 허훈 지예섭 황순휘 진성호 이상억 박지호 서경원 박성수 김찬영 In-Hwan Kim 손명원 박경호 Sungsoo Kim Moon-Soo Lee

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제20권 제2호

발행연도: 2020.1

수록면: 152 - 164 (13page)

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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.

참고문헌 (14)

참고문헌 신청

Sakuramoto S / 2007 / Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine / N Engl J Med 357:1810~1820

Bang YJ / 2012 / Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy(CLASSIC) : a phase 3 open-label, randomised controlled trial / Lancet 379:315~321

Kim IH / 2018 / Efficacy of adjuvant S-1 versus XELOX chemotherapy for patients with gastric cancer after D2 lymph node dissection : a retrospective, multi-center observational study / Ann Surg Oncol 25:1176~1183

Guideline Committee of the Korean Gastric Cancer Association / 2019 / Korean Practice Guideline for Gastric Cancer 2018; Evidence-based, Multi-disciplinary Approach / Journal of Gastric Cancer 19(1):1~48

Japanese Gastric Cancer Association / 2017 / Japanese gastric cancer treatment guidelines 2014 (ver. 4) / Gastric Cancer 20:1~19

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