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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2017

01-09-2017 | Gastrointestinal Oncology

Risk Factors for Poor Compliance with Adjuvant S-1 Chemotherapy for Gastric Cancer: A Multicenter Retrospective Study

Authors: Kotaro Yamashita, MD, Yukinori Kurokawa, MD, FACS, Kazuyoshi Yamamoto, MD, Masashi Hirota, MD, Ryohei Kawabata, MD, Jota Mikami, MD, Toru Masuzawa, MD, Shuji Takiguchi, MD, Masaki Mori, MD, FACS, Yuichiro Doki, MD

Published in: Annals of Surgical Oncology | Issue 9/2017

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Abstract

Background

Curative gastrectomy followed by adjuvant S-1 chemotherapy for 12 months is one of the standard treatments for patients with pathological stage (p-stage) II or III gastric cancer. Although some patients have difficulty maintaining compliance with adjuvant S-1, the risk factors for poor compliance are unknown.

Methods

We retrospectively analyzed the data of patients at 21 institutions who underwent curative gastrectomy followed by adjuvant S-1 for p-stage II or III gastric cancer. Patients who had a recurrence within 12 months after surgery were excluded from the analysis. Associations between clinicopathological factors and both 12-month compliance and the cumulative continuation rate of S-1 were analyzed.

Results

Of 359 patients, 252 (70.2%) continued adjuvant S-1 until 12 months after surgery. Older age (>65 years) and postoperative infectious complications (Clavien–Dindo grade III or higher) were significantly correlated with low compliance with S-1 for 12 months (p = 0.008 and p = 0.042). These two factors also showed significant associations with low cumulative continuation rate (log-rank p < 0.001 and p = 0.018). Continuation rates at 12 months after surgery in patients aged ≤60 years, 61–65, 66–70, 71–75, and 76–80 years were 81.5, 75.9, 65.4, 58.7, and 62.9%, respectively. Type of gastrectomy or body weight loss at 1 month after surgery did not affect either 12-month compliance or the cumulative continuation rate of S-1.

Conclusions

Older age, especially over 65 years, and postoperative infectious complications were independent risk factors for poor compliance with adjuvant S-1 chemotherapy for gastric cancer.
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Metadata
Title
Risk Factors for Poor Compliance with Adjuvant S-1 Chemotherapy for Gastric Cancer: A Multicenter Retrospective Study
Authors
Kotaro Yamashita, MD
Yukinori Kurokawa, MD, FACS
Kazuyoshi Yamamoto, MD
Masashi Hirota, MD
Ryohei Kawabata, MD
Jota Mikami, MD
Toru Masuzawa, MD
Shuji Takiguchi, MD
Masaki Mori, MD, FACS
Yuichiro Doki, MD
Publication date
01-09-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5923-2

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