Does the Timing of Adjuvant Chemotherapy for Gastric Cancer Influence Patient Outcome?

PURPOSE: Although adjuvant chemotherapy is currently established as standard treatment in stage II/III gastric cancer, there is no report about the optimal timing of the initiation of chemotherapy. We investigated the effect of the interval between surgery and the start of chemotherapy on patient outcome. Patients and METHODS: A retrospective review was conducted of 410 patients who underwent 5-fluorouracil/mitomycin-C/polysaccharide-K adjuvant chemotherapy for stage IIA-IIIC gastric cancer after curative resection. Overall survival (OS) was compared among patients grouped by time from surgery to start of adjuvant chemotherapy. RESULTS: The median time from surgery to chemotherapy was 21 days (7-80 days). Seventyseven patients (18.8%) began adjuvant chemotherapy ≥28 days after surgery. The median follow-up duration was 150 months (97-195 months) for the survivors. There was no significant difference in 10-year OS between the patients who started chemotherapy <21 days after surgery and those who initiated it later (57.3% vs. 51.4%; p=.409). However, commencing chemotherapy ≥28 days after surgery was associated with inferior 10-year OS compared with earlier initiation (38.8% vs. 57.5%; p=.003), with a significant correlation in stage III (p<.0001) but not in stage II (p=.326). Furthermore, initiation of adjuvant chemotherapy ≥28 days after surgery was an independent prognostic factor of poor OS (p=.008), along with old age, large tumor size, Borrmann type IV, and advanced stages. CONCLUSION: It does not seem to be necessary to initiate adjuvant chemotherapy too early after gastric cancer surgery. However, it is desirable to start treatment within 4 weeks after surgery if patients have fully recovered, especially in those with stage III.

Author dc:creator

• 송, 가원

Contributors dc:contributor

• 강, 석윤
• 대학원 의학과
• 201124370

• 위암
• 보조항암화학요법
• Gastric cancer
• Adjuvant chemotherapy

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000016222
000000016222

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/10892