Favorable long-term outcomes of one-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer treated at a high-volume center
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One-year adjuvant S-1 monotherapy following D2 gastrectomy has been the Japanese treatment standard for pathological stage II or III gastric cancer since the Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer (ACTS-GC) was concluded in 2007. Trial patients were selected according to the 13th edition of the Japanese classification (JC-13). The JC-13 and the TNM classification underwent major revisions in 2010 (JC-14/TNM-7). However, neither the recent therapeutic results for patients with stage II/III disease defined by the current system nor comparisons with the ACTS-GC-results have been reported.
The 390 study patients had pathological stage II/III gastric cancer defined by the JC-14/TNM-7 and treated with S-1 following D2 gastrectomy between 2008 and 2012. The completion rate of 1-year S-1, first relapse site, and stage-specific survival according to the JC-14/TNM-7, JC-13, and TNM-6 were examined and the results compared with those of the ACTS-GC.
The completion rate for 1-year S-1 (69.5%) was slightly higher than in the ACTS-GC. The recurrence pattern was almost identical. The 5-year overall survival rates of pathological IIA, IIB, IIIA, IIIB, and IIIC in the JC-14/TNM-7 were 96.0, 85.5, 81.8, 72.0, and 51.1%, respectively. Their 5-year overall and relapse-free survival rates by the JC-13 and TNM-6 systems were favorable as compared to those of ACTS-GC patients for all substages.
Survival outcome shown in this study of patients treated with 1-year adjuvant S-1 after D2 gastrectomy at a high-volume cancer hospital will provide a reference for future adjuvant trials targeting JC-14/TNM-7 stage II/III disease.
KeywordsGastric cancer S-1 Adjuvant chemotherapy ACTS-GC
The authors declare that this study had no external funding.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to declare.
All procedures followed were in accordance with the ethical standards of the institutional and national committees governing human experimentation and in compliance with the Helsinki Declaration of 1964 and later versions.
Informed consent or an appropriate substitute was obtained from all patients prior to their inclusion in the study.
- 1.International Research Agency on Cancer. The GLOBOCAN Project. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed 1 Dec 2017.
- 2.National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology. Gastric cancer version 3. 2016.Google Scholar
- 3.Japanese Gastric Cancer Treatment Guidelines 2014 (ver. 4). Japanese Gastric Cancer Association Gastric Cancer. 2017;20:1–19.Google Scholar
- 7.Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma, 13th ed. Tokyo: Kanehara; 1998 (in Japanese).Google Scholar
- 8.Beahrs OH, Henson DH, Hutter RVP, Kennedy BJ. AJCC cancer staging manual. 4th ed. Philadelphia: Lippincott Company; 1992.Google Scholar
- 10.Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP. AJCC cancer staging manual, 5th ed. Philadelphia: Lippincott-Raven; 1997.Google Scholar
- 11.Sobin LH, Wittekind CH. TNM classification of malignant tumors (UICC), 5th ed. New York: Wiley; 1997.Google Scholar
- 13.Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma, 14th ed. Tokyo: Kanehara; 2010 (in Japanese).Google Scholar
- 14.Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual, 7th ed. Chicago: Springer; 2010.Google Scholar
- 15.Sobin LH, Wittekind C, Gospodarowicz M. TNM classification of malignant tumors (UICC), 7th ed. New York: Wiley; 2009.Google Scholar
- 17.Sobin LH, Wittekind Ch, editors. TNM classification of malignant tumors (UICC), 6th ed. New York: Wiley; 2002.Google Scholar