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Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study

Authors
 Seohee Choi  ;  Jae-Seok Min  ;  Sang-Ho Jeong  ;  Moon-Won Yoo  ;  Young-Gil Son  ;  Sung Jin Oh  ;  Jong-Han Kim  ;  Joong-Min Park  ;  Hoon Hur  ;  Ye Seob Jee  ;  Sun-Hwi Hwang  ;  Sung-Ho Jin  ;  Sang Eok Lee  ;  Young-Joon Lee  ;  Kyung Won Seo  ;  Sungsoo Park  ;  Chang Min Lee  ;  Chang Hyun Kim  ;  In Ho Jeong  ;  Han Hong Lee  ;  Sung Il Choi  ;  Sang-Il Lee  ;  Chan-Young Kim  ;  Hyundong Chae  ;  Myoung-Won Son  ;  Kyung Ho Pak  ;  Sungsoo Kim  ;  Moon-Soo Lee  ;  Hyoung-Il Kim 
Citation
 JOURNAL OF GASTRIC CANCER, Vol.22(1) : 67-77, 2022-03 
Journal Title
JOURNAL OF GASTRIC CANCER
ISSN
 2093-582X 
Issue Date
2022-03
Keywords
Adjuvant chemotherapy ; Elderly ; Gastric cancer ; Recurrence ; Survival
Abstract
Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years.

Materials and methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group.

Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072-3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550-5.692; P=0.001).

Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.
Files in This Item:
T202201363.pdf Download
DOI
10.5230/jgc.2022.22.e6
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188500
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