Advantages of adjuvant chemotherapy using S-1 following minimally invasive gastrectomy for gastric cancer versus open surgery: a propensity score-matched analysis.

IF 6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastric Cancer Pub Date : 2024-11-07 DOI:10.1007/s10120-024-01565-8

Motonari Ri, Naoki Nishie, Manabu Ohashi, Shota Fukuoka, Kensei Yamaguchi, Rie Makuuchi, Masaru Hayami, Tomoyuki Irino, Takeshi Sano, Souya Nunobe

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引用次数: 0

Abstract

Background: It is essential to ensure optimal adherence to adjuvant chemotherapy regimens following gastric cancer surgery. However, treatment intensity for S-1 as adjuvant chemotherapy has not as yet been compared between minimally invasive (MI) and open (Open) surgery.

Methods: We retrospectively compared dose modification of adjuvant S-1 between MI and Open surgery in patients undergoing R0 gastrectomy for gastric or esophago-gastric junction cancer at the Cancer Institute Hospital Tokyo, Japan, during the period from 2012 to 2022, and receiving S-1 for pStage II or S-1 plus docetaxel for pStage III as adjuvant chemotherapy. Propensity score matching (PSM) was conducted to adjust for possible confounders.

Results: In total, 323 patients were initially included. After PSM, 158 patients remained, 79 in each group. The adjuvant chemotherapy completion rates were similar in the two groups. However, the proportion of patients who required S-1 dose reduction was significantly lower in the MI than in the Open group (43.0% vs. 65.8%, p = 0.004). In addition, the MI group had significantly fewer patients requiring suspension of S-1 than the Open group (46.8% vs. 64.6%, p = 0.025). Moreover, the frequency of adverse events of grade ≥ 3 was significantly lower in the MI than in the Open group (17.7% vs. 31.7%, p = 0.042).

Conclusions: In adjuvant chemotherapy for gastric cancer, minimally invasive surgery may offer better treatment intensity for oral S-1 administration than open surgery.

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胃癌微创胃切除术后使用S-1辅助化疗与开腹手术相比的优势：倾向评分匹配分析。

背景：确保胃癌术后辅助化疗方案的最佳依从性至关重要。然而，S-1辅助化疗的治疗强度尚未在微创手术（MI）和开腹手术（Open）之间进行过比较：我们回顾性比较了 2012 年至 2022 年期间在日本东京癌症研究所医院接受 R0 胃切除术的胃癌或食管-胃交界处癌患者在微创手术和开放手术之间辅助 S-1 的剂量调整情况。研究人员进行了倾向评分匹配（PSM）以调整可能存在的混杂因素：结果：最初共纳入了 323 名患者。结果：最初共纳入 323 名患者，经过倾向评分匹配后，剩下 158 名患者，每组 79 名。两组患者的辅助化疗完成率相似。然而，MI 组需要减少 S-1 剂量的患者比例明显低于 Open 组（43.0% 对 65.8%，P = 0.004）。此外，MI 组需要暂停使用 S-1 的患者明显少于开放组（46.8% 对 64.6%，p = 0.025）。此外，MI组发生≥3级不良反应的频率明显低于开放组（17.7% vs. 31.7%，p = 0.042）：结论：在胃癌辅助化疗中，微创手术口服 S-1 的治疗强度可能优于开放手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastric Cancer 医学-胃肠肝病学

CiteScore

14.70

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.