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Proper timing of adjuvant chemotherapy affects survival in patients with stage 2 and 3 gastric cancer

 Hyung Soon Park  ;  Minkyu Jung  ;  Hyo Song Kim  ;  Hyoung-Il Kim  ;  Ji Yeong An  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Yong Il Kim  ;  Hyun Cheol Chung  ;  Sun Young Rha 
 ANNALS OF SURGICAL ONCOLOGY, Vol.22(1) : 224-231, 2015 
Journal Title
Issue Date
Adenocarcinoma, Mucinous/drug therapy ; Adenocarcinoma, Mucinous/mortality* ; Adenocarcinoma, Mucinous/pathology ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Carcinoma, Signet Ring Cell/drug therapy ; Carcinoma, Signet Ring Cell/mortality* ; Carcinoma, Signet Ring Cell/pathology ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/mortality* ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/mortality* ; Stomach Neoplasms/pathology ; Survival Rate ; Time Factors
Advanced gastric cancer ; Timing of adjuvant chemotherapy ; Survival
BACKGROUND: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated. METHODS: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy. RESULTS: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4-8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037). CONCLUSIONS: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Kim, Hyo Song(김효송) ORCID logo https://orcid.org/0000-0002-0625-9828
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Park, Hyung Soon(박형순)
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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