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The Effectiveness of Postoperative Chemotherapy on pT1bN0 and pT2N0 Gastric Cancer Patients with Risk Factors: An International Dual-Center Analysis

Authors
 Kun Yang  ;  Mo Xi Chen  ;  Yoon Young Choi  ;  Zong Guang Zhou  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Jian Kun Hu 
Citation
 YONSEI MEDICAL JOURNAL, Vol.62(2) : 109-117, 2021-02 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2021-02
MeSH
Chemotherapy, Adjuvant ; China ; Female ; Humans ; Internationality* ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms / drug therapy* ; Stomach Neoplasms / pathology ; Stomach Neoplasms / surgery* ; Survival Analysis
Keywords
Gastric cancer ; T1bN0 ; T2N0 ; chemotherapy ; gastrectomy ; survival
Abstract
Purpose: This study aimed to investigate the effectiveness of postoperative chemotherapy in pT1bN0 and pT2N0 gastric cancer patients with high risk factors.

Materials and methods: Clinicopathological data of gastric cancer patients, who had undergone gastrectomy in high volume centers in Korea and China and were finally diagnosed with pT1bN0 and pT2N0 between 2006 and 2010, were analyzed retrospectively. Survival analyses stratified by risk factors and multivariable analyses were performed.

Results: A total of 1509 patients were enrolled, with 41 (2.7%) patients receiving adjuvant chemotherapy after gastrectomy and 1468 (97.3%) patients undergoing surgery alone. The adjuvant chemotherapy group showed higher percentages of tumor with maximal diameter >3 cm (51.2% vs. 25.8%), poor differentiation (68.3% vs. 49.8%), and less harvested lymph nodes (17.1% vs. 5.2%) compared to the surgery alone group. The overall survival rates were 95.1% in the adjuvant chemotherapy group and 93.3% in the surgery alone group, without significant difference. In multivariable analysis, age was found to be an independent prognostic factor. However, there were no difference in the overall survival between patients with risk factors and those without risk factors, even in terms of age. Meanwhile, patients with more than two risk factors who received chemotherapy showed better survival trend, especially for pT2N0 patients, compared to the surgery alone group, although no significant differences were observed.

Conclusion: In pT1bN0 and pT2N0 patients, age was found to be an independent prognostic factor. However, adjuvant chemotherapy seemed to be unnecessary, while postoperative chemotherapy might offer survival benefits to pT2N0 patients with more than two risk factors.
Files in This Item:
T202125997.pdf Download
DOI
10.3349/ymj.2021.62.2.109
Appears in Collections:
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
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190351
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