Abstract
Background
Curative gastrectomy followed by adjuvant S-1 chemotherapy for 12 months is one of the standard treatments for patients with pathological stage (p-stage) II or III gastric cancer. Although some patients have difficulty maintaining compliance with adjuvant S-1, the risk factors for poor compliance are unknown.
Methods
We retrospectively analyzed the data of patients at 21 institutions who underwent curative gastrectomy followed by adjuvant S-1 for p-stage II or III gastric cancer. Patients who had a recurrence within 12 months after surgery were excluded from the analysis. Associations between clinicopathological factors and both 12-month compliance and the cumulative continuation rate of S-1 were analyzed.
Results
Of 359 patients, 252 (70.2%) continued adjuvant S-1 until 12 months after surgery. Older age (>65 years) and postoperative infectious complications (Clavien–Dindo grade III or higher) were significantly correlated with low compliance with S-1 for 12 months (p = 0.008 and p = 0.042). These two factors also showed significant associations with low cumulative continuation rate (log-rank p < 0.001 and p = 0.018). Continuation rates at 12 months after surgery in patients aged ≤60 years, 61–65, 66–70, 71–75, and 76–80 years were 81.5, 75.9, 65.4, 58.7, and 62.9%, respectively. Type of gastrectomy or body weight loss at 1 month after surgery did not affect either 12-month compliance or the cumulative continuation rate of S-1.
Conclusions
Older age, especially over 65 years, and postoperative infectious complications were independent risk factors for poor compliance with adjuvant S-1 chemotherapy for gastric cancer.
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Kotaro Yamashita, Yukinori Kurokawa, Kazuyoshi Yamamoto, Masashi Hirota, Ryohei Kawabata, Jota Mikami, Toru Masuzawa, Shuji Takiguchi, Masaki Mori, and Yuichiro Doki have no conflicts of interest or financial ties to disclose.
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Yamashita, K., Kurokawa, Y., Yamamoto, K. et al. Risk Factors for Poor Compliance with Adjuvant S-1 Chemotherapy for Gastric Cancer: A Multicenter Retrospective Study. Ann Surg Oncol 24, 2639–2645 (2017). https://doi.org/10.1245/s10434-017-5923-2
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DOI: https://doi.org/10.1245/s10434-017-5923-2