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Is adjuvant chemotherapy necessary in pT1N1 gastric cancer?

 Hyun Beak Shin  ;  Ji Yeong An  ;  Seung Hyoung Lee  ;  Yoon Young Choi  ;  Jong Won Kim  ;  Soo Sang Sohn  ;  Sung Hoon Noh 
 BMC CANCER, Vol.17(1) : 287, 2017 
Journal Title
Issue Date
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Body Mass Index ; Chemotherapy, Adjuvant/methods ; Female ; Gastrectomy ; Humans ; Male ; Neoplasm Recurrence, Local/epidemiology* ; Neoplasm Staging ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery ; Survival Analysis ; Treatment Outcome
Adjuvant chemotherapy ; Gastric cancer ; Recurrence ; Treatment strategy ; pT1N1
BACKGROUND: Due to a lack of consensus on adjuvant treatments for pT1N1 gastric cancer, surgeons face a dilemma when deciding treatments for patients with pT1N1 gastric cancer after gastrectomy. The objective of this study was to determine survival benefits of adjuvant chemotherapy and risk factors for tumor recurrence in gastric cancer patients with pT1N1. METHODS: Between 1996 and 2010, 510 patients who underwent curative resection for pT1N1 gastric cancer at three institutes were divided into two groups: adjuvant chemotherapy group (N = 150) and surgery-only group (N = 360). Disease-free survival rates and risk factors for tumor recurrence were analyzed. RESULTS: During the median follow-up of 78 months, 7.5% of patients experienced tumor recurrence (7.3% in adjuvant chemotherapy group and 7.5% in surgery-only group). The 5-year disease-free survival rate was 91.8% in the adjuvant chemotherapy group and 94.6% in the surgery-only group without significant difference between the two. In univariate analysis, older age (>65 years), male gender, body mass index <25 kg/m2, elevated gross type, and differentiated histology were associated with tumor recurrence. Multivariate analysis showed that advanced age and male gender were independent risk factors for tumor recurrence. In addition, adjuvant chemotherapy showed no benefitial effect on tumor recurrence in pT1N1 gastric cancer. CONCLUSIONS: Adjuvant chemotherapy did not show any oncologically benefitial effect on tumor recurrence, it might be unnecessary for pT1N1 gastric cancer after curative surgery.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
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