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Published in: Surgery Today 10/2020

01-10-2020 | Gastrectomy | Original Article

Facilitated completion of 1-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer by medical oncologists

Authors: Yosuke Kano, Manabu Ohashi, Naoki Hiki, Daisuke Takahari, Keisho Chin, Kensei Yamaguchi, Satoshi Ida, Koshi Kumagai, Takeshi Sano, Souya Nunobe

Published in: Surgery Today | Issue 10/2020

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Abstract

Purpose

Several factors are known to be significantly associated with a low completion rate of 1-year adjuvant S-1 monotherapy for gastric cancer. The present study investigated whether or not the specialties of physicians conducting adjuvant S-1 monotherapy affect the completion rate.

Methods

A total of 437 patients who underwent curative gastrectomy followed by adjuvant S-1 monotherapy for pathological stage II or III gastric cancer between 2008 and 2013 were retrospectively analyzed. Factors affecting completion of adjuvant S-1 monotherapy, including the physicians (medical oncologists or surgeons) administering S-1, were evaluated by a multivariate analysis. The relationship between patient factors and physicians was analyzed regarding the cumulative incidence of discontinuation. The number of times the dose was reduced, the schedule changed, or administration was suspended or delayed in patients completing adjuvant S-1 monotherapy was also counted.

Results

The multivariate analysis showed that old age (≥ 65 years old), excess body weight loss (≥ 15%), and surgeons were independently associated with discontinuation. In older patients, the cumulative incidence of discontinuation by medical oncologists was significantly lower than that by surgeons. Medical oncologists ensured that older patients continued S-1 by frequent suspension or a delay in each course.

Conclusions

Medical oncologists may facilitate completion of adjuvant S-1 monotherapy.
Literature
1.
go back to reference Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, ACTS-GC Group, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357:1810–20.CrossRef Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, ACTS-GC Group, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357:1810–20.CrossRef
2.
go back to reference Noh SH, Park SR, Yang HK, Chung HC, Chung IJ, Kim SW, et al. Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trial. Lancet Oncol. 2014;15:1389–96.CrossRef Noh SH, Park SR, Yang HK, Chung HC, Chung IJ, Kim SW, et al. Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trial. Lancet Oncol. 2014;15:1389–96.CrossRef
3.
go back to reference Yoshida K, Kodera Y, Kochi M, Ichikawa W, Kakeji Y, Sano T, et al. Addition of docetaxel to oral fluoropyrimidine improves efficacy in patients with stage III gastric cancer: interim analysis of JACCRO GC-07, a randomized controlled trial. J Clin Oncol. 2019;37:1296–304.CrossRef Yoshida K, Kodera Y, Kochi M, Ichikawa W, Kakeji Y, Sano T, et al. Addition of docetaxel to oral fluoropyrimidine improves efficacy in patients with stage III gastric cancer: interim analysis of JACCRO GC-07, a randomized controlled trial. J Clin Oncol. 2019;37:1296–304.CrossRef
4.
go back to reference Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yamaguchi T, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011;29:4387–93.CrossRef Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yamaguchi T, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011;29:4387–93.CrossRef
5.
go back to reference Sakuramoto S, Kikuchi S, Watanabe M. Efficacy of S-1 (oral fluoropyrimidine) for gastric cancer. Med Frontl (Saishin Igaku). 2009;64:1075–80 (in Japanese). Sakuramoto S, Kikuchi S, Watanabe M. Efficacy of S-1 (oral fluoropyrimidine) for gastric cancer. Med Frontl (Saishin Igaku). 2009;64:1075–80 (in Japanese).
6.
go back to reference Yoshikawa T, Terashima M, Mizusawa J, Nunobe S, Nishida Y, Yamada T, et al. Four courses versus eight courses of adjuvant S-1 for patients with stage II gastric cancer (JCOG1104 [OPAS-1]): an open-label, phase 3, non-inferiority, randomised trial. Lancet Gastroenterol Hepatol. 2019;4:208–16.CrossRef Yoshikawa T, Terashima M, Mizusawa J, Nunobe S, Nishida Y, Yamada T, et al. Four courses versus eight courses of adjuvant S-1 for patients with stage II gastric cancer (JCOG1104 [OPAS-1]): an open-label, phase 3, non-inferiority, randomised trial. Lancet Gastroenterol Hepatol. 2019;4:208–16.CrossRef
7.
go back to reference Yamashita K, Kurokawa Y, Yamamoto K, Hirota M, Kawabata R, Mikami J, et al. Risk factors for poor compliance with adjuvant S-1 chemotherapy for gastric cancer: a multicenter retrospective study. Ann Surg Oncol. 2017;24:2639–45.CrossRef Yamashita K, Kurokawa Y, Yamamoto K, Hirota M, Kawabata R, Mikami J, et al. Risk factors for poor compliance with adjuvant S-1 chemotherapy for gastric cancer: a multicenter retrospective study. Ann Surg Oncol. 2017;24:2639–45.CrossRef
8.
go back to reference Kawazoe H, Shimasaki M, Ueno M, Sumikawa S, Takatori S, Namba H, et al. Risk factors for discontinuation of S-1 adjuvant chemotherapy for gastric cancer. J Cancer. 2015;6:464–9.CrossRef Kawazoe H, Shimasaki M, Ueno M, Sumikawa S, Takatori S, Namba H, et al. Risk factors for discontinuation of S-1 adjuvant chemotherapy for gastric cancer. J Cancer. 2015;6:464–9.CrossRef
9.
go back to reference Aoyama T, Yoshikawa T, Hayashi T, Kuwabara H, Mikayama Y, Ogata T, et al. Risk factors for 6-month continuation of S-1 adjuvant chemotherapy for gastric cancer. Gastr Cancer. 2013;16:133–9.CrossRef Aoyama T, Yoshikawa T, Hayashi T, Kuwabara H, Mikayama Y, Ogata T, et al. Risk factors for 6-month continuation of S-1 adjuvant chemotherapy for gastric cancer. Gastr Cancer. 2013;16:133–9.CrossRef
10.
go back to reference Aoyama T, Yoshikawa T, Shirai J, Hayashi T, Yamada T, Tsuchida K, et al. Body weight loss after surgery is an independent risk factor for continuation of S-1 adjuvant chemotherapy for gastric cancer. Ann Surg Oncol. 2013;20:2000–6.CrossRef Aoyama T, Yoshikawa T, Shirai J, Hayashi T, Yamada T, Tsuchida K, et al. Body weight loss after surgery is an independent risk factor for continuation of S-1 adjuvant chemotherapy for gastric cancer. Ann Surg Oncol. 2013;20:2000–6.CrossRef
11.
go back to reference Min JS, Lee CM, Choi SI, Seo KW, Park DJ, Baik YH, et al. Who can perform adjuvant chemotherapy treatment for gastric cancer? A multicenter retrospective overview of the current status in Korea. J Gastric Cancer. 2018;18:264–73.CrossRef Min JS, Lee CM, Choi SI, Seo KW, Park DJ, Baik YH, et al. Who can perform adjuvant chemotherapy treatment for gastric cancer? A multicenter retrospective overview of the current status in Korea. J Gastric Cancer. 2018;18:264–73.CrossRef
12.
go back to reference Japanese Classification of Gastric Carcinoma. 3rd English edition, Japanese Gastric Cancer Association Gastric Cancer. 2011;14:101–12. Japanese Classification of Gastric Carcinoma. 3rd English edition, Japanese Gastric Cancer Association Gastric Cancer. 2011;14:101–12.
13.
go back to reference Tsujimoto H, Horiguchi H, Hiraki S, Yaguchi Y, Takahata R, Kumano I, et al. Tolerability of adjuvant chemotherapy with S-1 after curative resection in patients with stage II/III gastric cancer. Oncol Lett. 2012;4:1135–9.CrossRef Tsujimoto H, Horiguchi H, Hiraki S, Yaguchi Y, Takahata R, Kumano I, et al. Tolerability of adjuvant chemotherapy with S-1 after curative resection in patients with stage II/III gastric cancer. Oncol Lett. 2012;4:1135–9.CrossRef
Metadata
Title
Facilitated completion of 1-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer by medical oncologists
Authors
Yosuke Kano
Manabu Ohashi
Naoki Hiki
Daisuke Takahari
Keisho Chin
Kensei Yamaguchi
Satoshi Ida
Koshi Kumagai
Takeshi Sano
Souya Nunobe
Publication date
01-10-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 10/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-01995-8

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