Published in:
01-06-2013 | Gastrointestinal Oncology
Body Weight Loss After Surgery is an Independent Risk Factor for Continuation of S-1 Adjuvant Chemotherapy for Gastric Cancer
Authors:
Toru Aoyama, MD, Takaki Yoshikawa, MD, PhD, Junya Shirai, MD, Tsutomu Hayashi, MD, Takanobu Yamada, MD, Kazuhito Tsuchida, MD, Shinichi Hasegawa, MD, Haruhiko Cho, MD, Norio Yukawa, MD, Takashi Oshima, MD, PhD, Yasushi Rino, MD, Munetaka Masuda, MD, PhD, Akira Tsuburaya, MD
Published in:
Annals of Surgical Oncology
|
Issue 6/2013
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Abstract
Background
Compliance of S-1 adjuvant chemotherapy is not high. The aim of the present study is to clarify risk factors for continuation of S-1 after gastrectomy.
Methods
This retrospective study selected patients who underwent curative D2 surgery for gastric cancer, were diagnosed with stage 2/3 disease, creatinine clearance more than 60 ml/min, and received adjuvant S-1 at our institution between June of 2002 and December of 2011. Time to S-1 treatment failure (TTF) was calculated.
Results
A total of 103 patients were selected for the present study. When TTF curve stratified by each clinical factor was compared by the log-rank test, body weight loss (BWL) of 15 % was regarded as a critical point. Both univariate and multivariate Cox proportional hazard analyses demonstrated that BWL was the significant independent risk factor. Moreover, BWL remained a significant factor in both the univariate and multivariate analyses in the subset excluding 8 patients who discontinued S-1 because of recurrence. The 6-month continuation rate was 66.4 % in the patients with BWL < 15 and 36.4 % in patients with BWL ≥ 15 % (P = .017).
Conclusions
BWL was the most important risk factor for the compliance of adjuvant chemotherapy with S-1 in the patients with stage 2/3 gastric cancer who underwent D2 gastrectomy. To improve drug compliance that leads to survival, it is a key to maintain body weight before starting S-1 adjuvant. Our study emphasizes the requirement for adequate studies of perioperative nutritional intervention in patients who receive gastrectomy for advanced gastric cancer.