Postoperative adjuvant chemotherapy in patients with gastric cancer based on the Nationwide Gastric Cancer Registry in Japan

DOI Web Site 参考文献46件
  • Yamada Yasuhide
    Department of Medical Research, National Center for Global Health and Medicine, Tokyo, Japan.
  • Seto Yasuyuki
    National Cancer Center Hospital, Tokyo, Japan.
  • Yoshikawa Takaki
    Department of Gastric Surgery, National Cancer Center Hospital, Tokyo, Japan.
  • Takeuchi Hiroya
    Department of Surgery, Hamamatsu University, School of Medicine, Hamamatsu, Japan.
  • Kitagawa Yuko
    Department of Surgery, Keio University, School of Medicine, Tokyo, Japan.
  • Kodera Yasuhiro
    NHO Nagoya Medical Center, Nagoya, Japan.
  • Doki Yuichiro
    Osaka University, Osaka, Japan.
  • Yoshida Kazuhiro
    Gifu University, Gifu, Japan.
  • Muro Kei
    Department of Pharmacotherapy, Aichi Cancer Center, Nagoya, Japan.
  • Kabeya Yoshinori
    Healthcare & Life Sciences, IBM Japan, Ltd, Tokyo, Japan.
  • Kamada Ami
    Healthcare & Life Sciences, IBM Japan, Ltd, Tokyo, Japan.
  • Nagashima Kengo
    Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan.
  • Kumamaru Hiraku
    Department of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
  • Tachimori Hisateru
    Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.
  • Sasako Mitsuru
    Yodogawa Christian Hospital, Osaka, Japan.
  • Katai Hitoshi
    Tachikawa Hospital, Tokyo, Japan.
  • Konno Hiroyuki
    Hamamatsu University, School of Medicine, Hamamatsu, Japan.
  • Kakeji Yoshihiro
    Database Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan. Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

書誌事項

公開日
2025-02-28
DOI
  • 10.35772/ghm.2024.01080
公開者
国立研究開発法人 国立国際医療研究センター

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説明

<p>The nationwide registry of the Japanese Gastric Cancer Association contains data related to the efficacy of adjuvant chemotherapy and prognostic factors across this patient population; elderly patients with advanced resectable gastric cancer are especially prevalent. Here, we analyzed data from 34,931 patients, who were treated between 2011 and 2013 at 421 hospitals in Japan. Although adjuvant chemotherapy was effective overall, 75 years or older elderly patients had a worse prognosis compared to younger patients. The most administered adjuvant chemotherapy was S-1 monotherapy. Adjuvant S-1 monotherapy was also effective for patients with pT1N2, pT1N3, and pT3N0 stage II tumors, as well as patients with other stage II and III malignancies. Independent prognostic factors for poor overall and relapse-free survival in patients at both stage II and stage III were age 75 or older, male, preoperative Eastern Cooperative Oncology Group performance status (ECOG-PS) 1 or more, preoperative renal dysfunction, undifferentiated adenocarcinoma, undergoing total gastrectomy, open laparotomy, no adjuvant chemotherapy, D1 lymphadenectomy, residual tumor R1 or R2, and Clavien-Dindo classification grade II or higher. Age 75 or older, renal dysfunction, ECOG-PS 1 and total gastrectomy were also significant risk factors for postoperative complications and lower compliance with adjuvant chemotherapy. Our analysis also revealed that adjuvant chemotherapy after resection of cancer of gastric remnant and postoperative chemotherapy against CY1 gastric cancer were also effective. We conclude that adjuvant chemotherapy is effective for all stage II and III patients including age 75 or older gastric cancer patients, in addition to distal gastrectomy, proximal gastrectomy, and pylorus-preserving surgery to avoid total gastrectomy may improve surgical outcomes and quality of life for elderly patients. </p>

収録刊行物

  • Global Health & Medicine

    Global Health & Medicine 7 (1), 13-27, 2025-02-28

    国立研究開発法人 国立国際医療研究センター

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