Long-term Efficacy of S-1 Monotherapy or Capecitabine Plus Oxaliplatin as Adjuvant Chemotherapy for Patients with Stage II or III Gastric Cancer after Curative Gastrectomy: a Propensity Score-Matched Multicenter Cohort Study

• Published in: Journal of gastric cancer 2020, Vol.20 (2), p.152-164
• Main Authors: Lee, Chang Min, Yoo, Moon-Won, Son, Young-Gil, Oh, Sung Jin, Kim, Jong-Han, Kim, Hyoung-Il, Park, Joong-Min, Hur, Hoon, Jee, Ye Seob, Hwang, Sun-Hwi, Jin, Sung-Ho, Lee, Sang Eok, Park, Ji-Ho, Seo, Kyung Won, Park, Sungsoo, Kim, Chang Hyun, Jeong, In Ho, Lee, Han Hong, Choi, Sung Il, Lee, Sang-Il, Kim, Chan Young, Kim, In-Hwan, Son, Myoung-Won, Pak, Kyung Ho, Kim, Sungsoo, Lee, Moon-Soo, Min, Jae-Seok
• Format: Article
• Language: Korean
• ISSN: 2093-582X; 2093-5641

Purpose: To compare long-term disease-free survival (DFS) between patients receiving tegafur/gimeracil/oteracil (S-1) or capecitabine plus oxaliplatin (CAPOX) adjuvant chemotherapy (AC) for gastric cancer (GC). Materials and Methods: This retrospective multicenter observational study enrolled 983 patients who underwent curative gastrectomy with consecutive AC with S-1 or CAPOX for stage II or III GC at 27 hospitals in Korea between February 2012 and December 2013. We conducted propensity score matching to reduce selection bias. Long-term oncologic outcomes, including DFS rate over 5 years (over-5yr DFS), were analyzed postoperatively. Results: The median and longest follow-up period were 59.0 and 87.6 months, respectively. DFS rate did not differ between patients who received S-1 and CAPOX for pathologic stage II (P=0.677) and stage III (P=0.899) GC. Moreover, hazard ratio (HR) for recurrence did not differ significantly between S-1 and CAPOX (reference) in stage II (HR, 1.846; 95% confidence interval [CI], 0.693-4.919; P=0.220) and stage III (HR, 0.942; 95% CI, 0.664-1.337; P=0.738) GC. After adjustment for significance in multivariate analysis, pT (4 vs. 1) (HR, 11.667; 95% CI, 1.595-85.351; P=0.016), pN stage (0 vs. 3) (HR, 2.788; 95% CI, 1.502-5.174; P=0.001), and completion of planned chemotherapy (HR, 2.213; 95% CI, 1.618-3.028; P