Back to Search
Start Over
Efficacy of Postoperative Chemotherapy After Resection that Leaves No Macroscopically Visible Disease of Gastric Cancer with Positive Peritoneal Lavage Cytology (CY1) or Localized Peritoneum Metastasis (P1a): A Multicenter Retrospective Study.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2020 Jan; Vol. 27 (1), pp. 284-292. Date of Electronic Publication: 2019 Sep 18. - Publication Year :
- 2020
-
Abstract
- Background: Gastric cancer (GC) patients with positive peritoneal lavage cytology (CY1) and/or localized peritoneum metastasis (P1a) are defined as stage IV in the 15th edition of the Japanese Classification of Gastric Cancer. In Japan, the most common treatment for patients with CY1 and/or P1a is gastrectomy followed by postoperative chemotherapy.<br />Patients and Methods: Subjects in this multi-institutional retrospective study were GC patients with CY1 and/or P1a who received surgical resection that leaves no macroscopically visible disease. Patients were selected from 34 institutions in Japan between 2007 and 2012. Selection criteria included adenocarcinoma, no distant metastasis except CY1 and P1a, and no prior treatment for GC before surgery.<br />Results: Among 824 patients registered, 506 were identified as eligible, with a background of P0CY1, P1aCY0, or P1aCY1 (72.5%, 16.0%, and 11.5% of subjects, respectively). Sixty-two patients had not received postoperative chemotherapy (no-Cx), whereas 444 patients had received postoperative chemotherapy: S-1 monotherapy (S-1; n = 267, 52.7%), cisplatin plus S-1 (CS; n = 114, 22.5%), and others (n = 63, 12.6%). Overall survival (OS) was 29.5, 24.7, 25.4 and 9.9 months in the S-1, CS, 'others', and no-Cx groups, respectively [CS vs. S-1: hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.89-1.50; p = 0.275]. In multivariate analysis, OS was similar between the S-1 and CS groups (CS vs. S-1: HR 1.19, 95% CI 0.92-1.55; p = 0.18).<br />Conclusions: Postoperative chemotherapy after gastrectomy that leaves no macroscopically visible disease may have some survival benefits for GC patients with CY1 and/or P1a. In contrast, S-1 plus cisplatin seems to have no additional benefit over S-1 treatment alone.
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma pathology
Adenocarcinoma surgery
Adult
Aged
Aged, 80 and over
Combined Modality Therapy
Disease-Free Survival
Drug Combinations
Female
Gastrectomy
Humans
Japan
Male
Middle Aged
Neoplasm Recurrence, Local pathology
Peritoneal Cavity cytology
Peritoneal Lavage
Postoperative Period
Retrospective Studies
Stomach Neoplasms mortality
Stomach Neoplasms pathology
Stomach Neoplasms surgery
Survival Rate
Young Adult
Adenocarcinoma drug therapy
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Cisplatin administration & dosage
Oxonic Acid administration & dosage
Peritoneal Neoplasms secondary
Stomach Neoplasms drug therapy
Tegafur administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 31535301
- Full Text :
- https://doi.org/10.1245/s10434-019-07697-x