Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer

Hyung Soon Park, Minkyu Jung, Hyo Song Kim, Hyoung Il Kim, Ji Yeong An, Jae Ho Cheong, WooJin Hyung, Sung Hoon Noh, Yong Il Kim, Hyuncheol Chung, SunYoung Rha

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Abstract

Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.

Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.

Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4–8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037).

Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.

Original languageEnglish
Pages (from-to)224-231
Number of pages8
JournalAnnals of Surgical Oncology
Volume22
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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Adjuvant Chemotherapy
Stomach Neoplasms
Survival
Therapeutics
Health

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Park, Hyung Soon ; Jung, Minkyu ; Kim, Hyo Song ; Kim, Hyoung Il ; An, Ji Yeong ; Cheong, Jae Ho ; Hyung, WooJin ; Noh, Sung Hoon ; Kim, Yong Il ; Chung, Hyuncheol ; Rha, SunYoung. / Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 1. pp. 224-231.
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abstract = "Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 {\%}) patients (early group), 4–8 weeks in 467 (55.6 {\%}) patients (intermediate group), and more than 8 weeks in 36 (4.3 {\%}) patients (late group). The 5-year RFS was 55.7 {\%} in the early group, 54.4 {\%} in the intermediate group, and 43.6 {\%} in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 {\%} (p = 0.037).Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.",
author = "Park, {Hyung Soon} and Minkyu Jung and Kim, {Hyo Song} and Kim, {Hyoung Il} and An, {Ji Yeong} and Cheong, {Jae Ho} and WooJin Hyung and Noh, {Sung Hoon} and Kim, {Yong Il} and Hyuncheol Chung and SunYoung Rha",
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Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer. / Park, Hyung Soon; Jung, Minkyu; Kim, Hyo Song; Kim, Hyoung Il; An, Ji Yeong; Cheong, Jae Ho; Hyung, WooJin; Noh, Sung Hoon; Kim, Yong Il; Chung, Hyuncheol; Rha, SunYoung.

In: Annals of Surgical Oncology, Vol. 22, No. 1, 01.01.2015, p. 224-231.

Research output: Contribution to journalArticle

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T1 - Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer

AU - Park, Hyung Soon

AU - Jung, Minkyu

AU - Kim, Hyo Song

AU - Kim, Hyoung Il

AU - An, Ji Yeong

AU - Cheong, Jae Ho

AU - Hyung, WooJin

AU - Noh, Sung Hoon

AU - Kim, Yong Il

AU - Chung, Hyuncheol

AU - Rha, SunYoung

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N2 - Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4–8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037).Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.

AB - Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4–8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037).Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.

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