Kotaro Yamashita1, Yukinori Kurokawa2, Kazuyoshi Yamamoto3, Masashi Hirota4, Ryohei Kawabata5, Jota Mikami6, Toru Masuzawa7, Shuji Takiguchi1, Masaki Mori1, Yuichiro Doki1. 1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 2. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. ykurokawa@gesurg.med.osaka-u.ac.jp. 3. Department of Surgery, Osaka National Hospital, Osaka, Japan. 4. Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan. 5. Department of Surgery, Osaka Rosai Hospital, Osaka, Japan. 6. Department of Surgery, Sakai Municipal Hospital, Osaka, Japan. 7. Department of Surgery, Osaka Police Hospital, Osaka, Japan.
Abstract
BACKGROUND: Curative gastrectomy followed by adjuvant S-1 chemotherapy for 12 months is one of the standard treatments for patients with pathological stage (p-stage) II or III gastric cancer. Although some patients have difficulty maintaining compliance with adjuvant S-1, the risk factors for poor compliance are unknown. METHODS: We retrospectively analyzed the data of patients at 21 institutions who underwent curative gastrectomy followed by adjuvant S-1 for p-stage II or III gastric cancer. Patients who had a recurrence within 12 months after surgery were excluded from the analysis. Associations between clinicopathological factors and both 12-month compliance and the cumulative continuation rate of S-1 were analyzed. RESULTS: Of 359 patients, 252 (70.2%) continued adjuvant S-1 until 12 months after surgery. Older age (>65 years) and postoperative infectious complications (Clavien-Dindo grade III or higher) were significantly correlated with low compliance with S-1 for 12 months (p = 0.008 and p = 0.042). These two factors also showed significant associations with low cumulative continuation rate (log-rank p < 0.001 and p = 0.018). Continuation rates at 12 months after surgery in patients aged ≤60 years, 61-65, 66-70, 71-75, and 76-80 years were 81.5, 75.9, 65.4, 58.7, and 62.9%, respectively. Type of gastrectomy or body weight loss at 1 month after surgery did not affect either 12-month compliance or the cumulative continuation rate of S-1. CONCLUSIONS: Older age, especially over 65 years, and postoperative infectious complications were independent risk factors for poor compliance with adjuvant S-1 chemotherapy for gastric cancer.
BACKGROUND: Curative gastrectomy followed by adjuvant S-1 chemotherapy for 12 months is one of the standard treatments for patients with pathological stage (p-stage) II or III gastric cancer. Although some patients have difficulty maintaining compliance with adjuvant S-1, the risk factors for poor compliance are unknown. METHODS: We retrospectively analyzed the data of patients at 21 institutions who underwent curative gastrectomy followed by adjuvant S-1 for p-stage II or III gastric cancer. Patients who had a recurrence within 12 months after surgery were excluded from the analysis. Associations between clinicopathological factors and both 12-month compliance and the cumulative continuation rate of S-1 were analyzed. RESULTS: Of 359 patients, 252 (70.2%) continued adjuvant S-1 until 12 months after surgery. Older age (>65 years) and postoperative infectious complications (Clavien-Dindo grade III or higher) were significantly correlated with low compliance with S-1 for 12 months (p = 0.008 and p = 0.042). These two factors also showed significant associations with low cumulative continuation rate (log-rank p < 0.001 and p = 0.018). Continuation rates at 12 months after surgery in patients aged ≤60 years, 61-65, 66-70, 71-75, and 76-80 years were 81.5, 75.9, 65.4, 58.7, and 62.9%, respectively. Type of gastrectomy or body weight loss at 1 month after surgery did not affect either 12-month compliance or the cumulative continuation rate of S-1. CONCLUSIONS: Older age, especially over 65 years, and postoperative infectious complications were independent risk factors for poor compliance with adjuvant S-1 chemotherapy for gastric cancer.
Authors: Jae-Seok Min; Chang Min Lee; Sung Il Choi; Kyung Won Seo; Do Joong Park; Yong Hae Baik; Myoung-Won Son; Won Hyuk Choi; Sungsoo Kim; Kyung Ho Pak; Min Gyu Kim; Joong-Min Park; Sang Ho Jeong; Moon-Soo Lee; Sungsoo Park Journal: J Gastric Cancer Date: 2018-09-07 Impact factor: 3.720