Abstract
Aims
We previously demonstrated that body weight loss (BWL) at one month after gastrectomy, a common finding after surgery for gastric cancer, was an independent risk factor for the continuation of adjuvant chemotherapy with S-1. However, it is unclear whether BWL after gastrectomy leads to poor survival through poor compliance to adjuvant chemotherapy with S-1.
Methods
We conducted this follow-up study in the same cohort as our previous study. Overall survival (OS) and recurrence-free survival (RFS) were examined in 103 patients who underwent curative D2 surgery and were pathologically diagnosed with stage II or III gastric cancer, and who received postoperative adjuvant chemotherapy with S-1 between June 2002 and December 2011.
Results
The median follow-up period was 64.3 months. The 5-year OS rate in the patients with a BWL of <15% was 59.9%, while that in the patients with a BWL of ≥15% was 36.4% (p = 0.004). Univariate and multivariate analyses for OS demonstrated that pathological T factor and BWL were significant risk factors. On the other hand, the 5-year RFS rate was 56.4% in the BWL <15% group and 36.4% in the BWL ≥15% group (p = 0.016), while univariate and multivariate analyses for RFS demonstrated that BWL was a marginally significant risk factor.
Conclusions
Severe postoperative BWL, which is closely related with poor S-1 compliance, is an important risk factor for survival. It merits testing if preventing BWL improves survival of gastric cancer patients who receive S-1 adjuvant chemotherapy.
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Acknowledgements
This work was supported, in part, by the non-governmental organization, Kanagawa Standard Anti-cancer Therapy Support System, Uehara Memorial Foundation, the Yasuda Medical Foundation, and Takeda Medical Foundation. The authors express their sincere gratitude to Ms. Yuka Fujita, Ms. Natsumi Sato, and Ms. Rika Takahashi for their excellent data management in this study.
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The authors declare no conflicts of interest in association with the present study.
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T. Aoyama and T. Yoshikawa contributed equally to this study.
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Aoyama, T., Sato, T., Maezawa, Y. et al. Postoperative weight loss leads to poor survival through poor S-1 efficacy in patients with stage II/III gastric cancer . Int J Clin Oncol 22, 476–483 (2017). https://doi.org/10.1007/s10147-017-1089-y
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DOI: https://doi.org/10.1007/s10147-017-1089-y