Adjuvant chemotherapy for elderly patients (aged 70 or older) with gastric cancer after a gastrectomy with D2 dissection: A single center experience in Korea

Autor:	Jin H Baek, SuJin Koh, Gyu Yeol Kim, Hawk Kim, Jae-Cheol Jo, Byung G Kim, In D Jeong, Hong R Cho, Byung Uk Lee, Young Joo Min
Rok vydání:	2015
Předmět:	Chemotherapy medicine.medical_specialty business.industry medicine.medical_treatment Hazard ratio Cancer General Medicine Single Center medicine.disease Tegafur Gastroenterology Confidence interval Surgery Oncology Internal medicine medicine Gastrectomy Prospective cohort study business medicine.drug
Zdroj:	Asia-Pacific Journal of Clinical Oncology. 11:282-287
ISSN:	1743-7555
DOI:	10.1111/ajco.12349
Popis:	Aims Adjuvant chemotherapy is recommended for gastric cancer after a gastrectomy with D2 dissection. However, its survival benefit in elderly patients is unclear. Here we investigated the use of adjuvant chemotherapy in patients ≥70 years old with stage II or III gastric cancer. Methods Patients ≥70 years old diagnosed with stage II or III gastric cancer at Ulsan University Hospital were identified. A retrospective analysis of electronic and paper patient records was performed. Results From 2008 to 2012, 277 patients ≥70 years old underwent gastrectomy with D2 dissection. Of these patients, 94 were pathologically diagnosed with stage II or III; 55 of these patients (58.5%) received adjuvant chemotherapy and 39 received regular checkups without chemotherapy. Fluoropyrimidine-alone regimens, including TS-1 composed of tegafur, gimestat and otastat potassium (n = 26) and doxifluridine (n = 22), were more commonly used than fluoropyrimidine-platinum combination regimens (n = 7). With a median follow-up of 30.9 (range 0.8–65.5) months, the median relapse-free survival of patients with adjuvant chemotherapy or regular follow-up only was 35.5 and 20.4 months, respectively (P = 0.030). Multivariate analysis revealed that adjuvant chemotherapy is associated with longer relapse-free survival (hazard ratio 0.50; 95% confidence interval 0.27–0.96). There was a trend toward an improved overall survival in the adjuvant chemotherapy group compared with the follow-up only group (P = 0.242). Conclusions Although well-designed prospective studies are required, adjuvant chemotherapy may confer a potential survival benefit in elderly patients (aged 70 or older) with stage II or III gastric cancer after a gastrectomy with D2 dissection.
Databáze:	OpenAIRE
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