PURPOSE: Although several chemotherapy regimens used against advanced gastric cancer (AGC) have been studied extensively in an attempt to further improve the prognosis of patients, to date, no standard chemotherapeutic regimens have been established. The aim of this study was to determine the anti-tumor efficacy and safety of TS-1 or TS-1 plus cisplatin (CDDP). MATERIAL AND METHODS: We treated 78 patients with AGC either with 80 mg/m2 of TS-1 for 28 days, which was followed by a 2-week rest, or with 80 mg/m2 of TS-1 for 21 days and 60 mg/m2 of CDDP on day 8 every 5 weeks. RESULTS: Tumor response rates in the neoadjuvant chemotherapy group and in the recurrent or post-palliative surgery group were 87.5% and 32.4%, respectively, and they were 28.6% and 48.4%, respectively, in the TS-1 group and the TS-1 plus CDDP group. The survival rates in the recurrent and the post-palliative surgery group were significantly different according to the degree of tumor response (P=0.0016), but the one-year survival rates according to the kinds of regimens (TS-1 or TS-1/CDDP group) were not significantly different. The incidences of grade 3 or 4 adverse effects in the TS-1 and the TS-1/CDDP groups were 14.3% and 36.8%, respectively. CONCLUSION: The anti-tumor efficacy and safety of TS-1 and TS-1 plus CDDP in Korean patients with AGC seemed to be high with modest adverse effects, thus suggesting the possible use of this regimen as a standard chemotherapy for gastric cancer.
Cisplatin ; Drug Therapy ; Humans ; Incidence ; Prognosis ; Stomach Neoplasms* ; Survival Rate

PURPOSE: The aim of this study was to compare synchronous and metachronous hepatic metastases in patients with gastric cancer to determine clinicopathologic features and differences in prognosis as a function of the timing of the metastasis and the treatment modality rendered. MATERIALS AND METHODS: Sixty-seven patients who were diagnosed with gastric cancer metastatic to the liver and treated at the Hanyang University Hospital between June 1992 and December 2006 were retrospectively analyzed to study the pertinent clinicopathologic features and effect of treatment methods. RESULTS: There was a significant difference with respect to lymphatic (P=0.041) and vascular invasion (P=0.036) in comparing the clinicopathologic features between the patients with synchronous and metachronous hepatic metastases. The 1-year survival rate and median survival time of patients with gastric cancer and liver metastases were 38.9% and 9.2 months in the entire patient cohort, 30.9% and 9.2 months in the synchronous group, and 44.5% and 9.7 months in the metachronus group, respectively (P=0.436). The group of patients undergoing local treatment (such as surgery and radiologic intervention) followed by systemic chemotherapy, the group of patients receiving systemic chemotherapy only, and the untreated group of patients were compared, and there was no difference between the synchronous and metachronous groups. The synchronous and metachronous groups had high survival rates with local treatment. CONCLUSION: In patients with gastric cancer and liver metastases, there was no difference in prognosis based on the timing of the hepatic metastases. Independent of the timing of hepatic metastasis, aggressive treatment, such as surgery and radiologic intervention, may help improve the prognosis.
Cohort Studies ; Humans ; Liver ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate