Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2017; 23(41): 7407-7414
Published online Nov 7, 2017. doi: 10.3748/wjg.v23.i41.7407
Survival analysis based on human epidermal growth factor 2 status in stage II-III gastric cancer
Jang Ho Cho, Jae Yun Lim, Jae Yong Cho
Jang Ho Cho, Jae Yun Lim, Jae Yong Cho, Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, South Korea
Author contributions: Lim JY and Cho JY designed the study; Cho JH collected the data, performed data analysis and wrote the manuscript; Cho JH and Cho JY were involved in result interpretation and approved the final version of this manuscript.
Institutional review board statement: The study was approved by the Yonsei University Health System Institutional Review Board (IRB #3-2013-0188).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jae Yong Cho, MD, PhD, Department of Medical Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Dogok 1-dong, Gangnam-gu, Seoul 135-720, South Korea. chojy@yuhs.ac
Telephone: +82-2-20194363 Fax: +82-2-34633882
Received: July 12, 2017
Peer-review started: July 13, 2017
First decision: August 10, 2017
Revised: August 24, 2017
Accepted: September 6, 2017
Article in press: September 5, 2017
Published online: November 7, 2017
Processing time: 114 Days and 20.1 Hours
Abstract
AIM

To investigate human epidermal growth factor 2 (HER2) overexpression and validate its prognostic effect in stage II-III gastric cancer.

METHODS

We reviewed the data of patients who were diagnosed with gastric cancer between March 2008 and October 2013 at the Yonsei University Medical Center. Among these patients, 384 patients who met the inclusion criteria were analyzed retrospectively.

RESULTS

Thirty-two (8.3%) of the 384 stage II-III gastric cancer patients exhibited HER2 overexpression. The median follow-up duration was 26.0 mo. HER2-negative patients had superior recurrence-free survival (RFS) compared to HER2-positive patients (HR = 0.52, 95%CI: 0.30-0.89; P = 0.015). The median overall survival (OS) was significantly prolonged in the HER2-negative group compared with the HER2-positive group (55.0 mo vs 38.0 mo, HR = 0.43, 95%CI: 0.21-0.88, P = 0.021). OS was also prolonged in HER2-negative patients who received adjuvant chemotherapy compared to HER2-positive patients (55.0 vs 38.0 mo, HR = 0.42, 95%CI: 0.18-1.00, P = 0.051). In patients who did not receive adjuvant chemotherapy, the median RFS was prolonged in the HER2-negative group compared to the HER2-positive group (not reached vs 12.0 mo, HR = 0.17, 95%CI: 0.06-0.49, P = 0.001). In a multivariate analysis, HER2 status (HR = 0.421, 95%CI: 0.206-0.861, P = 0.018) and Eastern Cooperative Oncology Group performance status (HR = 2.002, 95%CI: 1.530-2.618, P < 0.001) were independent predictors of OS.

CONCLUSION

Our findings showed that HER2-positive patients had inferior OS and RFS. Stage II-III HER2-positive patients might be potential candidates for targeted therapies involving trastuzumab.

Keywords: Trastuzumab; Gastric neoplasm; Human epidermal growth factor 2

Core tip: Our study aimed to investigate human epidermal growth factor 2 (HER2) overexpression and validate its prognostic effect in stage II-III gastric cancer. Clinical data from 384 patients were analyzed. HER2-positive patients had inferior overall survival and recurrence-free survival. Stage II-III HER2-positive patients might be potential candidates for targeted therapies involving trastuzumab.