Copyright
©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Adjuvant chemotherapy with S-1 plus oxaliplatin improves survival of patients with gastric cancer after D2 gastrectomy: A multicenter propensity score-matched study
Deng-Feng Ren, Fang-Chao Zheng, Jun-Hui Zhao, Guo-Shuang Shen, Raees Ahmad, Shui-Sheng Zhang, Yu Zhang, Jie Kan, Li Dong, Zi-Yi Wang, Fu-Xing Zhao, Jiu-Da Zhao
Deng-Feng Ren, Jun-Hui Zhao, Raees Ahmad, Zi-Yi Wang, Fu-Xing Zhao, Jiu-Da Zhao, Department of Medical Oncology, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Fang-Chao Zheng, Department of Medical Oncology, Shouguang Hospital of Traditional Chinese Medicine, Weifang 262700, Shandong Province, China
Guo-Shuang Shen, Department of Surgical Oncology, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Shui-Sheng Zhang, Department of Pancreatic and Gastric Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Yu Zhang, Department of Medical Oncology, Qinghai Red Cross Hospital, Xining 810000, Qinghai Province, China
Jie Kan, Department of Medical Oncology, People’s Hospital of Qinghai Province, Xining 810000, Qinghai Province, China
Li Dong, Institutes of Biomedical Sciences, Shanxi University, Taiyuan 030006, Shanxi Province, China
Author contributions: Ren DF and Zheng FC contributed equally to this work; Zhao JD and Ren DF conceived, designed and wrote the manuscript; Zheng FC, Zhao JD, Zhang SS, Zhang Y, Kan J and Wang ZY collected the clinical data and followed up the patients; Ren DF, Zhao JH, Shen GS, Dong L and Zhao FX helped to analyze the data; Ren DF, Ahmad R, Zheng FC and Zhao JD revised the manuscript; Zhao JD provided financial support for this work; all authors read and approved the final manuscript.
Supported by the Thousand Talents of Program of High-end Innovation of Qinghai Province in China (For Jiuda Zhao); and the Clinical Oncology Medical Center of Qinghai Province in China, No. 2018-SF-113.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Qinghai University, People’s Hospital of Qinghai Province, Qinghai Red Cross Hospital, and Cancer Institute & Hospital, Chinese Academy of Medical Sciences.
Informed consent statement: All patients or their legal guardians signed informed consent statements.
Conflict-of-interest statement: All authors declare no conflict of interest.
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: Jiu-Da Zhao, MD, Professor, Department of Medical Oncology, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, No. 29, Tongren Road, Xining 810000, Qinghai Province, China.
jiudazhao@126.com
Telephone: +86-791-6162732 Fax: +81-971-6155740
Received: June 8, 2018
Peer-review started: June 8, 2018
First decision: July 3, 2018
Revised: July 17, 2018
Accepted: August 27, 2018
Article in press: August 28, 2018
Published online: September 26, 2018
Processing time: 110 Days and 18.8 Hours
ARTICLE HIGHLIGHTS
Research objectives
The main objectives of this retrospective study were to evaluate the safety and efficacy of S-1 plus oxaliplatin (SOX) as adjuvant chemotherapy for gastric cancer (GC) after D2 dissection.
Research methods
We collected patients with GC who underwent D2 gastrectomy from September 2009 to December 2011 in four Chinese institutions. Patients with stage IB-IIIC GC, who received adjuvant SOX treatment were matched by propensity scores with those who underwent surgery alone and those who conducted adjuvant capecitabine plus oxaliplatin (XELOX) regimen. We compared the estimated 5-year disease-free survival (DFS) and 5-year overall survival (OS) between the groups and analyzed adverse events in SOX patients.
Research results
In total, 867 GC patients were included for analysis. Among 124 patients treated with SOX regimen, 117 patients were matched to 234 patients who conducted surgery alone, and 57 patients were matched to 57 patients who received XELOX regimen. The estimated five-year DFS was 57.5% in the adjuvant SOX group and 44.6% in the surgery alone group (P = 0.001); and the estimated five-year OS was 68.3% and 45.8% (P < 0.001), respectively. Compared with XELOX regimen, SOX showed no significant difference in DFS and OS. The most common ≥ 3 grade adverse events of SOX regimen were neutropenia (22.6%), leukopenia (8.9%) and thrombocytopenia (5.6%).
Research conclusions
This study showed that compared with surgery alone, adjuvant SOX regimen significantly improves the long-term survival and have acceptable toxicity in patients with stage IB-IIIC GC after D2 dissection.
