Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2023; 15(1): 32-48
Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.32
Prognostic effect of excessive chemotherapy cycles for stage II and III gastric cancer patients after D2 + gastrectomy
Yi-Fan Li, Wen-Bing Zhang, Yu-Ye Gao
Yi-Fan Li, Department of General Surgery, Shanxi Province Cancer Hospital, Taiyuan 030013, Shanxi Province, China
Wen-Bing Zhang, Endoscopy Center, Shanxi Province Cancer Hospital, Taiyuan 030013, Shanxi Province, China
Yu-Ye Gao, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 00010, China
Author contributions: Li YF and Zhang WB conceptualized and designed the study, collected and analyzed the data, and wrote the manuscript; Li YF, Zhang WB and Gao YY revised the manuscript for important intellectual content; Gao YY participated in collection of the data; All authors approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Institutional Research Ethics Board of Ethics Committee of Shanxi Cancer Hospital (Taiyuan, China) (No. 2022JC23) and followed the Declaration of Helsinki.
Informed consent statement: All the authors report having no relevant conflicts of interest for this article.
Conflict-of-interest statement: No additional data are available.
Data sharing statement: The authors have read the STROBE Statement - checklist of items, and the manuscript was prepared and revised according to the STROBE Statement - checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: Wen-Bing Zhang, MD, Chief Doctor, Surgeon, Endoscopy Center, Shanxi Province Cancer Hospital, No. 3 Xinghualing District, Staff New Village, Taiyuan 030013, Shanxi Province, China.
Received: September 18, 2022
Peer-review started: September 18, 2022
First decision: October 20, 2022
Revised: November 4, 2022
Accepted: December 13, 2022
Article in press: December 13, 2022
Published online: January 27, 2023
Research background

Several studies have shown an oncological benefit with increased cycles of chemotherapy in different cancer types. However, some studies have shown no effect or a worsened effect.

Research motivation

According to a series of exploration and analysis, it is found that there is no abundant data to prove the correlation between the prognosis of gastric cancer and the duration of chemotherapy.

Research objectives

The main purpose of this study is to analyze and explore whether there is a correlation between survival rate and chemotherapy cycle in patients with stage II gastric cancer and stage III gastric cancer.

Research methods

A 1:1 ratio was used in the propensity score matching analysis to reduce the differences between groups with different chemotherapy cycles. Progression-free survival, overall survival and recurrence were components of outcome indicators.

Research results

There was no statistically significant difference in progression-free survival and overall survival between the two groups of stage II and III patients. However, overall recurrence (P < 0.001), local-regional metastasis (P = 0.002), and distant metastasis (P = 0.001) in the ≥ 9 chemotherapy cycles group were significantly lower than those in the < 9 chemotherapy cycles group for stage III gastric cancer patients.

Research conclusions

For stage II and III gastric cancer patients, ≥ 9 cycles of chemotherapy should not be considered as far as possible, because ≥ 9 cycles of chemotherapy cannot effectively reduce the recurrence rate.

Research perspectives

After a series of studies, it is found that the relationship between the prognosis of gastric cancer and the chemotherapy cycle needs to be further explored to make a more abundant and standardized chemotherapy regimen.