Clinical significance of secreted protein, acidic and cysteine-rich gene expression in patients with stage II/III gastric cancer following curative resection and adjuvant chemotherapy with S-1.

The standard treatment for stage II/III gastric cancer is surgical resection followed by adjuvant chemotherapy with fluoropyrimidine anticancer agents, including S-1. The protein, secreted protein, acidic and cysteine-rich (SPARC), promotes angiogenesis, and the proliferation and migration of cancer cells. The present study evaluated the significance of expression of the SPARC gene in patients with stage II/III gastric cancer who had undergone surgical resection and adjuvant chemotherapy with S-1. In the present study, reverse transcription-quantitative polymerase chain reaction was performed in order to quantify mRNA expression levels of SPARC in cancer tissues and adjacent normal mucosa obtained from 134 patients with stage II/III gastric cancer who had undergone surgical resection followed by adjuvant chemotherapy with S-1. The mRNA expression level of SPARC was significantly higher in cancer tissues than in adjacent normal mucosa (P=0.0012). Additionally, the 5-year overall survival rate was significantly poorer in patients with high SPARC gene expression than in those with low expression (P<0.0001). Furthermore, multivariate analysis indicated that high SPARC mRNA expression was a significant predictor of poorer survival in patients with stage II/III gastric cancer who had undergone surgical resection and adjuvant chemotherapy with S-1 (HR, 5.347; P<0.0001). Therefore, high expression of the SPARC gene may be a useful predictor of outcomes in patients with stage II/III gastric cancer, who have received treatment involving surgical resection and adjuvant chemotherapy with S-1.