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Is There Any Role of Adjuvant Chemotherapy for T3N0M0 or T1N2M0 Gastric Cancer Patients in Stage II in the 7th TNM but Stage I in the 6th TNM System?

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Controversy surrounds adjuvant chemotherapy (CTx) for T3N0M0 and T1N2M0 in the American Joint Committee on Cancer (AJCC) 7th edition stage IIA gastric cancer patients. The purpose of this study was to evaluate the benefit of adjuvant CTx for stage IIA cancer, including T3N0M0 and T1N2M0.

Methods

A total of 630 patients with stage IIA cancer who underwent a radical gastrectomy between January 1999 and December 2009 at Seoul National University Hospital were retrospectively analyzed. We compared the outcomes of 434 patients who did not receive CTx (the non-CTx group) with those of 196 patients who received CTx comprising of 5-fluorouracil-based regimens (the CTx group).

Results

The 5-year overall survival (OS) rates of the non-CTx and CTx groups were 86.4 and 89.3 %, respectively (p = 0.047). In the subgroup analysis of T2N1M0 (6th II/7th IIA), there was a significant difference in OS between the non-CTx and CTx groups (p = 0.003), but no differences were observed in T3N0M0 and T1N2M0 (6th IB/7th IIA) (p = 0.574 and p = 0.934). The multivariate analysis showed that a tumor size greater than 5 cm in T3N0M0 [odds ratio (OR) 1.929; p = 0.030], no adjuvant CTx in T2N1M0 (OR 4.853; p = 0.025), and no factors in T1N2M0 were found to be risk factors for recurrence-free survival.

Conclusions

Adjuvant CTx may be associated with an improved outcome of patients with T2N1M0 (6th II/7th IIA), but not T3N0M0 or T1N2M0 (6th IB/7th IIA), gastric cancer. To confirm these results, further studies are needed.

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Acknowledgment

This study was supported by a Grant from the Doosan Yonkang Foundation (30-2011-0080) and a grant from the Seoul National University College of Medicine Research Fund (800-20130197).

Conflict of interest

Kyung-Goo Lee, Hyuk-Joon Lee, Seung-Young Oh, Jun-Young Yang, Hye-Seong Ahn, Yun-Suhk Suh, Seong-Ho Kong, Tae-Yong Kim, Do-Youn Oh, Seock-Ah Im, Kuhn Uk Lee, Woo Ho Kim, Yung-Jue Bang, and Han-Kwang Yang declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Kyung-Goo Lee MD, Hyuk-Joon Lee MD, PhD, Seung-Young Oh MD, Jun-Young Yang MD, Hye-Seong Ahn MD, Yun-Suhk Suh MD, Seong-Ho Kong MD, PhD, Kuhn Uk Lee MD, PhD & Han-Kwang Yang MD, PhD

  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Tae-Yong Kim MD, PhD, Do-Youn Oh MD, PhD, Seock-Ah Im MD, PhD & Yung-Jue Bang MD, PhD

  3. Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

    Woo Ho Kim MD, PhD

  4. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Hyuk-Joon Lee MD, PhD, Do-Youn Oh MD, PhD, Seock-Ah Im MD, PhD, Yung-Jue Bang MD, PhD & Han-Kwang Yang MD, PhD

  5. Department of Surgery, Myongji Hospital, Goyang, Korea

    Kyung-Goo Lee MD & Kuhn Uk Lee MD, PhD

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Correspondence to Hyuk-Joon Lee MD, PhD.

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Lee, KG., Lee, HJ., Oh, SY. et al. Is There Any Role of Adjuvant Chemotherapy for T3N0M0 or T1N2M0 Gastric Cancer Patients in Stage II in the 7th TNM but Stage I in the 6th TNM System?. Ann Surg Oncol 23, 1234–1243 (2016). https://doi.org/10.1245/s10434-015-4980-7

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  • DOI: https://doi.org/10.1245/s10434-015-4980-7

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