BACKGROUND: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated. METHODS: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy. RESULTS: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4-8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037). CONCLUSIONS: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.
BACKGROUND: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated. METHODS:Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy. RESULTS: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4-8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037). CONCLUSIONS: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.
Authors: Cornelius A Thiels; Naruhiko Ikoma; Keith Fournier; Prajnan Das; Mariela Blum; Jeannelyn S Estrella; Bruce D Minsky; Jaffer Ajani; Paul Mansfield; Brian D Badgwell Journal: J Surg Oncol Date: 2018-06-07 Impact factor: 3.454
Authors: Yoontaek Lee; Sa-Hong Min; Ki Bum Park; Young Suk Park; Ji-Won Kim; Sang-Hoon Ahn; Jin Won Kim; Do Joong Park; Keun-Wook Lee; Hyung-Ho Kim Journal: J Gastric Cancer Date: 2018-03-20 Impact factor: 3.720
Authors: Huizheng Bao; Na Xu; Zhongkun Li; Hongtao Ren; Hong Xia; Na Li; Hao Yu; Janbiao Wei; Chengyi Jiang; Lu Liu Journal: Medicine (Baltimore) Date: 2017-05 Impact factor: 1.889