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Annals of Surgical Oncology

, Volume 20, Issue 6, pp 2000–2006 | Cite as

Body Weight Loss After Surgery is an Independent Risk Factor for Continuation of S-1 Adjuvant Chemotherapy for Gastric Cancer

  • Toru Aoyama
  • Takaki Yoshikawa
  • Junya Shirai
  • Tsutomu Hayashi
  • Takanobu Yamada
  • Kazuhito Tsuchida
  • Shinichi Hasegawa
  • Haruhiko Cho
  • Norio Yukawa
  • Takashi Oshima
  • Yasushi Rino
  • Munetaka Masuda
  • Akira Tsuburaya
Gastrointestinal Oncology

Abstract

Background

Compliance of S-1 adjuvant chemotherapy is not high. The aim of the present study is to clarify risk factors for continuation of S-1 after gastrectomy.

Methods

This retrospective study selected patients who underwent curative D2 surgery for gastric cancer, were diagnosed with stage 2/3 disease, creatinine clearance more than 60 ml/min, and received adjuvant S-1 at our institution between June of 2002 and December of 2011. Time to S-1 treatment failure (TTF) was calculated.

Results

A total of 103 patients were selected for the present study. When TTF curve stratified by each clinical factor was compared by the log-rank test, body weight loss (BWL) of 15 % was regarded as a critical point. Both univariate and multivariate Cox proportional hazard analyses demonstrated that BWL was the significant independent risk factor. Moreover, BWL remained a significant factor in both the univariate and multivariate analyses in the subset excluding 8 patients who discontinued S-1 because of recurrence. The 6-month continuation rate was 66.4 % in the patients with BWL < 15 and 36.4 % in patients with BWL ≥ 15 % (P = .017).

Conclusions

BWL was the most important risk factor for the compliance of adjuvant chemotherapy with S-1 in the patients with stage 2/3 gastric cancer who underwent D2 gastrectomy. To improve drug compliance that leads to survival, it is a key to maintain body weight before starting S-1 adjuvant. Our study emphasizes the requirement for adequate studies of perioperative nutritional intervention in patients who receive gastrectomy for advanced gastric cancer.

Keywords

Gastric Cancer Adjuvant Chemotherapy Advanced Gastric Cancer Body Weight Loss Oral Rehydration Solution 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This work was supported, in part, by the non-governmental organization, Kanagawa Standard Anti-cancer Therapy Support System.

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Toru Aoyama
    • 1
    • 2
  • Takaki Yoshikawa
    • 1
    • 2
  • Junya Shirai
    • 1
    • 2
  • Tsutomu Hayashi
    • 1
    • 2
  • Takanobu Yamada
    • 1
    • 2
  • Kazuhito Tsuchida
    • 1
    • 2
  • Shinichi Hasegawa
    • 1
    • 2
  • Haruhiko Cho
    • 1
  • Norio Yukawa
    • 2
  • Takashi Oshima
    • 3
  • Yasushi Rino
    • 2
  • Munetaka Masuda
    • 2
  • Akira Tsuburaya
    • 1
  1. 1.Department of Gastrointestinal SurgeryKanagawa Cancer CenterYokohamaJapan
  2. 2.Department of SurgeryYokohama City UniversityYokohamaJapan
  3. 3.Department of SurgeryGastroenterological Center, Yokohama City University Medical CenterYokohamaJapan

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