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Erschienen in: Annals of Surgical Oncology 2/2016

01.02.2016 | Gastrointestinal Oncology

S-1 Adjuvant Chemotherapy Earlier After Surgery Clinically Correlates with Prognostic Factors for Advanced Gastric Cancer

verfasst von: Manabu Yamamoto, MD, PhD, FACS, Yoshihisa Sakaguchi, MD, PhD, FACS, Nao Kinjo, MD, PhD, Shohei Yamaguchi, MD, PhD, Akinori Egashira, MD, PhD, Kazuhito Minami, MD, PhD, Yasuharu Ikeda, MD, PhD, Masaru Morita, MD, PhD, FACS, Yasushi Toh, MD, PhD, FACS, Takeshi Okamura, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 2/2016

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Abstract

Background

S-1 adjuvant chemotherapy is commonly administered postoperatively for stage II and III advanced gastric cancer.

Methods

This study included 113 patients treated with S-1 adjuvant chemotherapy after surgery for stage II and III advanced gastric cancer. These patients were divided into 4 groups: group A (n = 63), who had a longer duration (≥6 months) and earlier S-1 administration (≤6 weeks) after surgery; group B (n = 16), who had a longer and later S-1 administration (>6 weeks) after surgery; group C (n = 27), who had a shorter duration (<6 months) and earlier S-1 administration after surgery; and group D (n = 7), who had a shorter and later S-1 administration after surgery.

Results

The recurrence rates in groups A, B, C, and D were 15.7, 43.8, 44.4, and 57.1 %, respectively (A vs. B, p < 0.05, A vs. C and D, p < 0.01). The survival time of group A was significantly longer than that of other groups (p < 0.005). In addition, the survival time of patients with severe complications was significantly shorter than that of patients with non-severe complications (p < 0.05). An earlier S-1 administration after surgery was the only independent prognostic factor in the multivariate analysis.

Conclusions

The prognosis of advanced gastric cancer was significantly related to the start of S-1 adjuvant treatment within 6 weeks after surgery.
Literatur
1.
Zurück zum Zitat Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2001;357:1810–20.CrossRef Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2001;357:1810–20.CrossRef
2.
Zurück zum Zitat Japanese Gastric Cancer Association. Gastric Cancer Treatment Guideline. 3rd ed. Tokyo, Japan: Kanehara, 2010. Japanese Gastric Cancer Association. Gastric Cancer Treatment Guideline. 3rd ed. Tokyo, Japan: Kanehara, 2010.
3.
Zurück zum Zitat Early Breast Cancer Trialists’ Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet. 2005;365:1687–717.CrossRef Early Breast Cancer Trialists’ Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet. 2005;365:1687–717.CrossRef
4.
Zurück zum Zitat Tancini G, Bonadonna G, Valagussa P, Marchini S, Veronesi U. Adjuvant CMF in breast cancer: comparative 5-year results of 12 versus 6 cycles. J Clin Oncol. 1983;1:2–10.PubMed Tancini G, Bonadonna G, Valagussa P, Marchini S, Veronesi U. Adjuvant CMF in breast cancer: comparative 5-year results of 12 versus 6 cycles. J Clin Oncol. 1983;1:2–10.PubMed
5.
Zurück zum Zitat O’Connel MJ, Laurie JA, Kahan M, et al. Prospectively randomized trial of postoperative adjuvant chemotherapy in patients with high-risk colon cancer. J Clin Oncol. 1998;16:295–300. O’Connel MJ, Laurie JA, Kahan M, et al. Prospectively randomized trial of postoperative adjuvant chemotherapy in patients with high-risk colon cancer. J Clin Oncol. 1998;16:295–300.
6.
Zurück zum Zitat Kuebler JP, Wieand HS, O’Connel MJ, et al. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007;25:2198–204.PubMedCrossRef Kuebler JP, Wieand HS, O’Connel MJ, et al. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007;25:2198–204.PubMedCrossRef
7.
Zurück zum Zitat Andre T, Boni C, Navarro M, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as surgical treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009;27:3109–16.PubMedCrossRef Andre T, Boni C, Navarro M, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as surgical treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009;27:3109–16.PubMedCrossRef
8.
Zurück zum Zitat Haller DG, Tabernero J, Maroun J, et al. Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer. J Clin Oncol. 2011;29:1465–71.PubMedCrossRef Haller DG, Tabernero J, Maroun J, et al. Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer. J Clin Oncol. 2011;29:1465–71.PubMedCrossRef
9.
Zurück zum Zitat Hershman D, Hall MJ, Wang X, Jacobson JS, McBrode R, Grann VR, Neugut AI. Timing of adjuvant chemotherapy initiation after surgery for stage III colon cancer. Cancer. 2006;107:2581–8.PubMedCrossRef Hershman D, Hall MJ, Wang X, Jacobson JS, McBrode R, Grann VR, Neugut AI. Timing of adjuvant chemotherapy initiation after surgery for stage III colon cancer. Cancer. 2006;107:2581–8.PubMedCrossRef
10.
Zurück zum Zitat Biagi JJ, Raphael MJ, Mackillop WJ, Kong W, King WD, Booth CM. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer. JAMA. 2011;305:2335–42.PubMedCrossRef Biagi JJ, Raphael MJ, Mackillop WJ, Kong W, King WD, Booth CM. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer. JAMA. 2011;305:2335–42.PubMedCrossRef
11.
Zurück zum Zitat Walker KG, Bell SW, Rickard MJ, Mehanna D, Dent OF, Chapuis PH, Bokey EL. Anastomotic leakage is predictive of diminished survival after potentially curative resection for colorectal cancer. Ann Surg. 2004;240:255–9.PubMedPubMedCentralCrossRef Walker KG, Bell SW, Rickard MJ, Mehanna D, Dent OF, Chapuis PH, Bokey EL. Anastomotic leakage is predictive of diminished survival after potentially curative resection for colorectal cancer. Ann Surg. 2004;240:255–9.PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat McArdle CS, McMillan DC, Hole DJ. Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancer. Br J Surg. 2005;92:1150–4.PubMedCrossRef McArdle CS, McMillan DC, Hole DJ. Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancer. Br J Surg. 2005;92:1150–4.PubMedCrossRef
13.
Zurück zum Zitat Lerut T, Moons J, Coosemans W, et al. Postoperative complications after transthoracic esophagectomy for cancer of the esophagus and gastroesophageal junction are correlated with early cancer recurrence: role of systemic grading of complications using the modified Clavien classification. Ann Surg. 2009;250:798–807.PubMedCrossRef Lerut T, Moons J, Coosemans W, et al. Postoperative complications after transthoracic esophagectomy for cancer of the esophagus and gastroesophageal junction are correlated with early cancer recurrence: role of systemic grading of complications using the modified Clavien classification. Ann Surg. 2009;250:798–807.PubMedCrossRef
14.
Zurück zum Zitat Rizk NP, Bach PB, Schrag D, et al. The impact of complications on outcomes after resection for esophageal and gastroesophageal junction carcinoma. J Am Coll Surg. 2004;198:42–50.PubMedCrossRef Rizk NP, Bach PB, Schrag D, et al. The impact of complications on outcomes after resection for esophageal and gastroesophageal junction carcinoma. J Am Coll Surg. 2004;198:42–50.PubMedCrossRef
15.
Zurück zum Zitat Sierzega M, Kolodziejczyk P, Kulig J; Polish Gastric Cancer Study Group. Impact of anastomotic leakage on longer-term survival after total gastrectomy for carcinoma of the stomach. Br J Surg. 2010;97:1035–42.PubMedCrossRef Sierzega M, Kolodziejczyk P, Kulig J; Polish Gastric Cancer Study Group. Impact of anastomotic leakage on longer-term survival after total gastrectomy for carcinoma of the stomach. Br J Surg. 2010;97:1035–42.PubMedCrossRef
16.
Zurück zum Zitat Yoo HM, Lee HH, Shim JH, Jeon HM, Park CH, Song KY. Negative impact of leakage on survival of patients undergoing curative resection for advanced gastric cancer. J Surg Oncol. 2011;104:734–40.PubMedCrossRef Yoo HM, Lee HH, Shim JH, Jeon HM, Park CH, Song KY. Negative impact of leakage on survival of patients undergoing curative resection for advanced gastric cancer. J Surg Oncol. 2011;104:734–40.PubMedCrossRef
17.
Zurück zum Zitat Kubota T, Hiki N, Sano T, et al. Prognostic significance of complications after curative surgery for gastric cancer. Ann Surg Oncol. 2014;21:891–8.PubMedCrossRef Kubota T, Hiki N, Sano T, et al. Prognostic significance of complications after curative surgery for gastric cancer. Ann Surg Oncol. 2014;21:891–8.PubMedCrossRef
18.
Zurück zum Zitat de Melo Gagliato D, Gonzalez-Angulo AM, Lei X, et al. Clinical impact of delaying initiation of adjuvant chemotherapy in patients with breast cancer. J Clin Oncol. 2014;32:735–44.CrossRef de Melo Gagliato D, Gonzalez-Angulo AM, Lei X, et al. Clinical impact of delaying initiation of adjuvant chemotherapy in patients with breast cancer. J Clin Oncol. 2014;32:735–44.CrossRef
19.
Zurück zum Zitat Japanese Gastric Cancer Association. Japan Classification of Gastric Carcinoma, 14th ed. Japan: Kanehara, 2010. Japanese Gastric Cancer Association. Japan Classification of Gastric Carcinoma, 14th ed. Japan: Kanehara, 2010.
20.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedPubMedCentralCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedPubMedCentralCrossRef
21.
Zurück zum Zitat Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.PubMedCrossRef Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.PubMedCrossRef
22.
Zurück zum Zitat Cox DR. Regression models and life tables. J R Stat B. 1972;35:187–220. Cox DR. Regression models and life tables. J R Stat B. 1972;35:187–220.
23.
Zurück zum Zitat Sasako M, Sakuramoto S, Katai H, et al. Five-year outcome of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011;29:4387–93.PubMedCrossRef Sasako M, Sakuramoto S, Katai H, et al. Five-year outcome of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011;29:4387–93.PubMedCrossRef
24.
Zurück zum Zitat Folkman J. What is the evidence that tumors are angiogenesis dependent? J Natl Cancer Inst. 1990;82:4–6.PubMedCrossRef Folkman J. What is the evidence that tumors are angiogenesis dependent? J Natl Cancer Inst. 1990;82:4–6.PubMedCrossRef
25.
Zurück zum Zitat Fider IJ, Ellis LM. The implications of angiogenesis for the biology and therapy of cancer metastasis. Cell. 1994;79:185–8.CrossRef Fider IJ, Ellis LM. The implications of angiogenesis for the biology and therapy of cancer metastasis. Cell. 1994;79:185–8.CrossRef
26.
Zurück zum Zitat Eggermont AM, Steller EP, Sugarbaker PH. Laparotomy enhances intraperitoneal tumor growth and abrogates the antitumor effects of interleukin-2 and lymphokine-activated killer cells. Surgery. 1987;102:71–8.PubMed Eggermont AM, Steller EP, Sugarbaker PH. Laparotomy enhances intraperitoneal tumor growth and abrogates the antitumor effects of interleukin-2 and lymphokine-activated killer cells. Surgery. 1987;102:71–8.PubMed
27.
Zurück zum Zitat Ono I, Gunji H, Suda K, Iwatsuki K, Kaneko F. Evaluation of cytokines in donor site wound fluids. Scand J Plast Reconstr Surg Hand Surg. 1994;28:269–73.PubMedCrossRef Ono I, Gunji H, Suda K, Iwatsuki K, Kaneko F. Evaluation of cytokines in donor site wound fluids. Scand J Plast Reconstr Surg Hand Surg. 1994;28:269–73.PubMedCrossRef
28.
Zurück zum Zitat Kerbel RS, Kamen BA. The anti-angiogenic basis of metronomic chemotherapy. Nat Rev Cancer. 2004;4:423–36.PubMedCrossRef Kerbel RS, Kamen BA. The anti-angiogenic basis of metronomic chemotherapy. Nat Rev Cancer. 2004;4:423–36.PubMedCrossRef
29.
Zurück zum Zitat Mimori K, Fukagawa T, Kosaka Y, et al. Hematogenous metastasis in gastric cancer requires isolated tumor cells and expression of vascular endothelial growth factor receptor-1. Clin Cancer Res. 2008;14:2609–16.PubMedCrossRef Mimori K, Fukagawa T, Kosaka Y, et al. Hematogenous metastasis in gastric cancer requires isolated tumor cells and expression of vascular endothelial growth factor receptor-1. Clin Cancer Res. 2008;14:2609–16.PubMedCrossRef
30.
Zurück zum Zitat Arigami T, Uenosono Y, Hirata M, Yanagita S, Ishigami S, Natsugoe S. B7-H3 expression in gastric cancer: a novel molecular blood marker for detecting circulating tumor cells. Cancer Sci. 2011;102:1019–24.PubMedCrossRef Arigami T, Uenosono Y, Hirata M, Yanagita S, Ishigami S, Natsugoe S. B7-H3 expression in gastric cancer: a novel molecular blood marker for detecting circulating tumor cells. Cancer Sci. 2011;102:1019–24.PubMedCrossRef
31.
Zurück zum Zitat Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454:436–44.PubMedCrossRef Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454:436–44.PubMedCrossRef
32.
Zurück zum Zitat McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Cur Opin Clin Nutr Metab Care. 2009;12:223–6.CrossRef McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Cur Opin Clin Nutr Metab Care. 2009;12:223–6.CrossRef
Metadaten
Titel
S-1 Adjuvant Chemotherapy Earlier After Surgery Clinically Correlates with Prognostic Factors for Advanced Gastric Cancer
verfasst von
Manabu Yamamoto, MD, PhD, FACS
Yoshihisa Sakaguchi, MD, PhD, FACS
Nao Kinjo, MD, PhD
Shohei Yamaguchi, MD, PhD
Akinori Egashira, MD, PhD
Kazuhito Minami, MD, PhD
Yasuharu Ikeda, MD, PhD
Masaru Morita, MD, PhD, FACS
Yasushi Toh, MD, PhD, FACS
Takeshi Okamura, MD, PhD
Publikationsdatum
01.02.2016
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 2/2016
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4868-6

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