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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2016

01-04-2016 | Gastrointestinal Oncology

Is There Any Role of Adjuvant Chemotherapy for T3N0M0 or T1N2M0 Gastric Cancer Patients in Stage II in the 7th TNM but Stage I in the 6th TNM System?

Authors: Kyung-Goo Lee, MD, Hyuk-Joon Lee, MD, PhD, Seung-Young Oh, MD, Jun-Young Yang, MD, Hye-Seong Ahn, MD, Yun-Suhk Suh, MD, Seong-Ho Kong, MD, PhD, Tae-Yong Kim, MD, PhD, Do-Youn Oh, MD, PhD, Seock-Ah Im, MD, PhD, Kuhn Uk Lee, MD, PhD, Woo Ho Kim, MD, PhD, Yung-Jue Bang, MD, PhD, Han-Kwang Yang, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2016

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Abstract

Background

Controversy surrounds adjuvant chemotherapy (CTx) for T3N0M0 and T1N2M0 in the American Joint Committee on Cancer (AJCC) 7th edition stage IIA gastric cancer patients. The purpose of this study was to evaluate the benefit of adjuvant CTx for stage IIA cancer, including T3N0M0 and T1N2M0.

Methods

A total of 630 patients with stage IIA cancer who underwent a radical gastrectomy between January 1999 and December 2009 at Seoul National University Hospital were retrospectively analyzed. We compared the outcomes of 434 patients who did not receive CTx (the non-CTx group) with those of 196 patients who received CTx comprising of 5-fluorouracil-based regimens (the CTx group).

Results

The 5-year overall survival (OS) rates of the non-CTx and CTx groups were 86.4 and 89.3 %, respectively (p = 0.047). In the subgroup analysis of T2N1M0 (6th II/7th IIA), there was a significant difference in OS between the non-CTx and CTx groups (p = 0.003), but no differences were observed in T3N0M0 and T1N2M0 (6th IB/7th IIA) (p = 0.574 and p = 0.934). The multivariate analysis showed that a tumor size greater than 5 cm in T3N0M0 [odds ratio (OR) 1.929; p = 0.030], no adjuvant CTx in T2N1M0 (OR 4.853; p = 0.025), and no factors in T1N2M0 were found to be risk factors for recurrence-free survival.

Conclusions

Adjuvant CTx may be associated with an improved outcome of patients with T2N1M0 (6th II/7th IIA), but not T3N0M0 or T1N2M0 (6th IB/7th IIA), gastric cancer. To confirm these results, further studies are needed.
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Metadata
Title
Is There Any Role of Adjuvant Chemotherapy for T3N0M0 or T1N2M0 Gastric Cancer Patients in Stage II in the 7th TNM but Stage I in the 6th TNM System?
Authors
Kyung-Goo Lee, MD
Hyuk-Joon Lee, MD, PhD
Seung-Young Oh, MD
Jun-Young Yang, MD
Hye-Seong Ahn, MD
Yun-Suhk Suh, MD
Seong-Ho Kong, MD, PhD
Tae-Yong Kim, MD, PhD
Do-Youn Oh, MD, PhD
Seock-Ah Im, MD, PhD
Kuhn Uk Lee, MD, PhD
Woo Ho Kim, MD, PhD
Yung-Jue Bang, MD, PhD
Han-Kwang Yang, MD, PhD
Publication date
01-04-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4980-7

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