Journal of Cancer Research and Clinical Oncology

, Volume 136, Issue 7, pp 1059–1064 | Cite as

Progression-free survival in first-line chemotherapy is a prognostic factor in second-line chemotherapy in patients with advanced gastric cancer

  • Kenji Hashimoto
  • Atsuo Takashima
  • Kengo Nagashima
  • Shun-suke Okazaki
  • Takako Eguchi Nakajima
  • Ken Kato
  • Tetsuya Hamaguchi
  • Yasuhide Yamada
  • Yasuhiro Shimada
Original Paper

Abstract

Purpose

First-line chemotherapy (Cx-1) in advanced gastric cancer (AGC) provides survival benefit. However, it is unclear who should proceed to second-line chemotherapy (Cx-2).

Methods

We reviewed patients who received Cx-2 for AGC following progressive disease after Cx-1 from 2000 to 2005 at the National Cancer Center Hospital, Tokyo. To evaluate the prognostic factors in Cx-2, Cox regression multivariate analysis was performed.

Results

Of 995 patients who received Cx-1 in this study period, 466 met the eligibility criteria. The median progression-free survival in Cx-1 (PFS-1) was 133 days. The median survival time from the date of starting second-line chemotherapy (MST-2) was 207 days. Multivariate analysis revealed that the factors affecting short survival time in Cx-2 were poor performance status (>2), low serum albumin level (<3.5 mg/dL), elevated C-reactive protein level (>1.0 mg/dL), patients with bone, liver or peritoneal metastasis, and patients without previous gastrectomy (p < 0.01). PFS-1 was an independent prognostic factor for survival (PFS-1 <120, MST-2 133 days, PFS-1 >120, MST-2 258 days, hazard ratio 0.71, 95% confidence interval 0.58–0.86, p < 0.01). The Cx-2 regimen (irinotecan vs. taxane) did not correlate with survival.

Conclusion

PFS-1 is one of the prognostic factors of Cx-2 in patients with AGC.

Keywords

Advanced gastric cancer Second-line chemotherapy Prognostic factor Time to progression Survival 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Kenji Hashimoto
    • 1
  • Atsuo Takashima
    • 1
  • Kengo Nagashima
    • 2
  • Shun-suke Okazaki
    • 1
  • Takako Eguchi Nakajima
    • 1
  • Ken Kato
    • 1
  • Tetsuya Hamaguchi
    • 1
  • Yasuhide Yamada
    • 1
  • Yasuhiro Shimada
    • 1
  1. 1.Gastrointestinal Oncology DivisionNational Cancer Center HospitalChuuou-kuTokyoJapan
  2. 2.Faculty of Pharmaceutical SciencesJosai UniversitySakadoJapan

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