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
- Author:
Chang Min LEE
1
;
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
Author Information
- Publication Type:Original Article
- From:Journal of Gastric Cancer 2020;20(2):152-164
- CountryRepublic of Korea
- Language:English
-
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.
