A total of 268 patients diagnosed with stage II or III PCC-GC were included. GC cell lines were also analyzed for drug sensitivity to 5-fluorouracil (5-FU) and oxaliplatin in vitro.
One hundred fifteen (42.9%) patients were stage II and 153 (57.1%) were stage III. Two hundred twenty-three (83.2%) patients received adjuvant therapy. Among these patients, 139 (62.3%) received CAPOX and 84 (37.7%) received S-1. With a median follow-up of 38.9 (1.6-137.8) months, the estimated 5-year disease-free survival (DFS) and overall survival (OS) rates were 52.3% and 61.0%, respectively. In the univariate analysis, survival was significantly better in the adjuvant chemotherapy group than in the surgery only group. In the subgroup analysis, there was no significant difference in DFS or OS between the types of adjuvant chemotherapy for either disease stage. In vitro cell line analysis, different responses to 5-FU and oxaliplatin were observed in SRC and non-SRC, where the treatment in KATOIII cell lines with oxaliplatin had less effect at a higher concentration compared to non-SRC cell lines.
The current study found that adjuvant chemotherapy was not significantly associated with survival benefit for patients with resected stage II and III PCC-GC. Plus, S-1 showed numerically longer DFS and OS compared to CAPOX in PCC-GC patients, although no significant in the multivariate analysis.
方法:共纳入268例诊断为II或III期PCC-GC的患者。还在体外分析了GC细胞系对5-氟尿嘧啶(5-FU)和奥沙利铂的药物敏感性。
结果:115例(42.9%)患者为II期,153例(57.1%)为III期。23例(83.2%)患者接受辅助治疗。在这些患者中,139人(62.3%)获得CAPOX,84人(37.7%)获得S-1。中位随访时间为38.9(1.6-137.8)个月,估计5年无病生存率(DFS)和总生存率(OS)分别为52.3%和61.0%,分别。在单变量分析中,辅助化疗组的生存率明显优于单纯手术组.在亚组分析中,对于任一疾病阶段,两种辅助化疗类型之间的DFS或OS均无显著差异.体外细胞系分析,在SRC和非SRC中观察到对5-FU和奥沙利铂的不同反应,其中与非SRC细胞系相比,在KATOIII细胞系中用奥沙利铂处理在较高浓度下的效果较小。
结论:目前的研究发现,对于II期和III期PCC-GC切除患者,辅助化疗与生存获益无显著相关。另外,在PCC-GC患者中,与CAPOX相比,S-1显示出数字上更长的DFS和OS,尽管在多变量分析中没有显著意义。