Analysis of outcomes according to start timing of adjuvant chemotherapy in patients with gastric cancer: a retrospective nationwide cohort study.

IF 4.8 2区医学 Q1 ONCOLOGY

Oncologist Pub Date : 2025-06-04 DOI:10.1093/oncolo/oyaf132

Tae-Hwan Kim, Eunyoung Lee, Hyun Woo Lee, Mi Sun Ahn, Yong Won Choi, Minsuk Kwon, Seok Yun Kang, Bumhee Park, Jin-Hyuk Choi

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引用次数: 0

Abstract

Background: Gastrectomy with D2 lymph node dissection followed by adjuvant chemotherapy (AC) with S-1 or capecitabine/oxaliplatin (CAPOX) is the standard treatment for stage II and III gastric cancer (GC). However, there is no established guideline for the start timing of AC.

Methods: We analyzed data from the Korean Health Insurance Review and Assessment Service on 19 140 GC patients who received AC with S-1 (n = 10 442) or CAPOX (n = 8698) between January 2014 and December 2018. Patients were categorized based on AC initiation timing: within 6 weeks (n = 12 843), 6-8 weeks (n = 5386), and >8-16 weeks (n = 911).

Results: Initiating AC within 6 weeks significantly improved 5-year disease-free survival (DFS) and overall survival (OS) compared to later initiation, with consistent findings across both S-1 and CAPOX groups (all P < .005). These associations remained significant in multivariable analysis and after propensity score matching (all P < .0001). However, this nationwide big-data analysis has limitations, including potential survival status misclassification and the absence of some important variables such as pathologic stage, performance status, and postoperative complications.

Conclusion: To optimize outcomes, AC for GC should be initiated within 6 weeks after gastrectomy, provided patients have fully recovered.

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胃癌患者辅助化疗起始时间的结局分析：一项回顾性全国队列研究。

背景：胃切除术并D2淋巴结清扫后辅助化疗（AC） S-1或卡培他滨/奥沙利铂（CAPOX）是II期和III期胃癌（GC）的标准治疗方法。方法：我们分析了2014年1月至2018年12月期间接受AC合并S-1 （n = 10442）或CAPOX （n = 8698）的19140例GC患者的数据。患者根据AC起始时间进行分类：6周内（n = 12 843）， 6-8周（n = 5386）和bb0 8-16周（n = 911）。结果：与较晚开始治疗相比，在6周内开始治疗可显著提高5年无病生存期（DFS）和总生存期（OS）， S-1组和CAPOX组的研究结果一致（均为P）。结论：为了优化结果，如果患者完全康复，胃癌治疗应在胃切除术后6周内开始治疗。

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

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.