Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: a retrospective nationwide cohort study

Background One-year S-1 or six-month capecitabine/oxaliplatin (CAPOX) has been the standard adjuvant chemotherapy for gastric cancer (GC). We investigated outcomes according to the cycles of adjuvant chemotherapy, using data from the Korean Health Insurance and Assessment Service. Methods A total of...

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Bibliographic Details
Published in:BMC cancer 2022-09, Vol.22 (1), p.1-948, Article 948
Main Authors: Kim, Tae-Hwan, Ahn, Mi Sun, Choi, Yong Won, Kang, Seok Yun, Choi, Jin-Hyuk, Lee, Hyun Woo, Park, Minae, Kim, Hasung
Format: Article
Language:English
Subjects:
Adjuvant
Adjuvant treatment
Big Data
Cancer
Cancer therapies
Care and treatment
Chemotherapy
Chronic obstructive pulmonary disease
Cohort analysis
Data analysis
Diabetes
Gastric cancer
Gastrointestinal surgery
Health insurance
Hypertension
Medical records
Nationwide cohort study
Oxaliplatin
Patients
Stomach cancer
Survival
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Summary:Background One-year S-1 or six-month capecitabine/oxaliplatin (CAPOX) has been the standard adjuvant chemotherapy for gastric cancer (GC). We investigated outcomes according to the cycles of adjuvant chemotherapy, using data from the Korean Health Insurance and Assessment Service. Methods A total of 20,552 patients, including 13,614 patients who received S-1 and 6,938 patients who received CAPOX extracted from 558,442 patients were retrospectively analyzed. The five-year overall survival rate was evaluated according to the duration of adjuvant chemotherapy. Results The five-year overall survival rate gradually increased according to the increase in adjuvant chemotherapy cycles in both the S-1 ([less than or equai to] 5 cycles: 48.4%, hazard ratio [HR] 4.06, 95% confidence interval [CI] 3.74-4.40, P < 0.0001; 5 < cycles [less than or equai to] 6: 55.4%, HR 3.08, 95% CI 2.65-3.57, P < 0.0001; 6 < cycles [less than or equai to] 7: 64.1%, HR 2.11, 95% CI 1.84-2.41, P < 0.0001; 7 < cycles < 8: 71.1%, HR 1.60, 95% CI 1.39-1.84, P < 0.0001; [greater than or equal to] 8 cycles: 77.9%) and the CAPOX groups ([less than or equai to] 4 cycles: 43.5%, HR 3.20, 95% CI 2.84-3.61, P < 0.0001; 5 cycles: 45.3%, HR 2.63, 95% CI 2.11-3.27, P < 0.0001; 6 cycles: 47.1%, HR 2.09, 95% CI 1.76-2.49, P < 0.0001; 7 cycles: 55.3%, HR 1.63, 95% CI 1.35-1.96, P < 0.0001; [greater than or equal to] 8 cycles: 67.2%). Conclusions Reducing the treatment cycles of adjuvant chemotherapy in GC with S-1 or CAPOX showed inferior survival outcomes. Completing the standard duration of adjuvant chemotherapy with S-1 or CAPOX would be strongly recommended. Keywords: Adjuvant, Chemotherapy, Gastric cancer, Survival, Nationwide cohort study
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-022-10006-7