Publisher: John Wiley & Sons Inc
E-ISSN: 1743-7563|11|4|282-287
ISSN: 1743-7555
Source: ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Vol.11, Iss.4, 2015-12, pp. : 282-287
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Abstract
AbstractAimsAdjuvant chemotherapy is recommended for gastric cancer after a gastrectomy with D2 dissection. However, its survival benefit in elderly patients is unclear. Here we investigated the use of adjuvant chemotherapy in patients ≥70 years old with stage II or III gastric cancer.MethodsPatients ≥70 years old diagnosed with stage II or III gastric cancer at Ulsan University Hospital were identified. A retrospective analysis of electronic and paper patient records was performed.ResultsFrom 2008 to 2012, 277 patients ≥70 years old underwent gastrectomy with D2 dissection. Of these patients, 94 were pathologically diagnosed with stage II or III; 55 of these patients (58.5%) received adjuvant chemotherapy and 39 received regular checkups without chemotherapy. Fluoropyrimidine‐alone regimens, including TS‐1 composed of tegafur, gimestat and otastat potassium (n = 26) and doxifluridine (n = 22), were more commonly used than fluoropyrimidine‐platinum combination regimens (n = 7). With a median follow‐up of 30.9 (range 0.8–65.5) months, the median relapse‐free survival of patients with adjuvant chemotherapy or regular follow‐up only was 35.5 and 20.4 months, respectively (P = 0.030). Multivariate analysis revealed that adjuvant chemotherapy is associated with longer relapse‐free survival (hazard ratio 0.50; 95% confidence interval 0.27–0.96). There was a trend toward an improved overall survival in the adjuvant chemotherapy group compared with the follow‐up only group (P = 0.242).ConclusionsAlthough well‐designed prospective studies are required, adjuvant chemotherapy may confer a potential survival benefit in elderly patients (aged 70 or older) with stage II or III gastric cancer after a gastrectomy with D2 dissection.