Abstract：
BACKGROUND: Whether adjuvant chemotherapy should be different for patients with stage II and III gastric cancer is unknown.
METHODS: We retrospectively analyzed the effects of adjuvant chemotherapy on the outcomes of 140 and 256 patients with stage II and III gastric cancer, respectively, between January 2008 and December 2018. Chemotherapies were stratified as fluoropyrimidine plus platinum versus fluoropyrimidine alone, tegafur/gimeracil/octeracil (S-1)-containing versus non-S-1-containing regimens, and S-1 plus cisplatin versus S-1 alone.
RESULTS: The median age of patients was 67.0 (range 24.6-98.8) years. With a median follow-up of 105 months, recurrence occurred in 32 (22.9%) and 130 (50.8%) patients with stage II and III disease, respectively. Adjuvant chemotherapy was administered as fluoropyrimidine monotherapy to 68 (48.6%) and 73 (28.5%) patients, fluoropyrimidine plus platinum to 9 (6.4%) and 104 (40.6%) patients, and none to 63 (45.0%) and 79 (30.9%) patients with stage II and III gastric cancer, respectively. Doublet chemotherapy was associated with longer disease-free survival (DFS) (26.5 vs. 15.2 months, P = 0.001) and overall survival (OS) (41.2 vs. 22.0 months, P < 0.001) than fluoropyrimidine monotherapy for stage IIIB-IIIC disease. Furthermore, S-1-containing regimens prolonged DFS (57.4 vs. 21.9 months, P = 0.044) and OS (81.4 vs. 28.6 months, P = 0.023) compared with non-S-1-containing chemotherapy in stage III disease.
CONCLUSIONS: Although fluoropyrimidine monotherapy is feasible for stage II-IIIA disease, doublet chemotherapy is significantly associated with longer survival than monotherapy for stage IIIB-IIIC disease. S-1-containing regimens might lead to longer survival than non-S-1-containing chemotherapy in stage III gastric cancer.
METHODS: We retrospectively analyzed the effects of adjuvant chemotherapy on the outcomes of 140 and 256 patients with stage II and III gastric cancer, respectively, between January 2008 and December 2018. Chemotherapies were stratified as fluoropyrimidine plus platinum versus fluoropyrimidine alone, tegafur/gimeracil/octeracil (S-1)-containing versus non-S-1-containing regimens, and S-1 plus cisplatin versus S-1 alone.
RESULTS: The median age of patients was 67.0 (range 24.6-98.8) years. With a median follow-up of 105 months, recurrence occurred in 32 (22.9%) and 130 (50.8%) patients with stage II and III disease, respectively. Adjuvant chemotherapy was administered as fluoropyrimidine monotherapy to 68 (48.6%) and 73 (28.5%) patients, fluoropyrimidine plus platinum to 9 (6.4%) and 104 (40.6%) patients, and none to 63 (45.0%) and 79 (30.9%) patients with stage II and III gastric cancer, respectively. Doublet chemotherapy was associated with longer disease-free survival (DFS) (26.5 vs. 15.2 months, P = 0.001) and overall survival (OS) (41.2 vs. 22.0 months, P < 0.001) than fluoropyrimidine monotherapy for stage IIIB-IIIC disease. Furthermore, S-1-containing regimens prolonged DFS (57.4 vs. 21.9 months, P = 0.044) and OS (81.4 vs. 28.6 months, P = 0.023) compared with non-S-1-containing chemotherapy in stage III disease.
CONCLUSIONS: Although fluoropyrimidine monotherapy is feasible for stage II-IIIA disease, doublet chemotherapy is significantly associated with longer survival than monotherapy for stage IIIB-IIIC disease. S-1-containing regimens might lead to longer survival than non-S-1-containing chemotherapy in stage III gastric cancer.
摘要：
背景：对于II期和III期胃癌患者，辅助化疗是否不同尚不清楚。
方法：我们回顾性分析了辅助化疗对140和256例II期和III期胃癌患者预后的影响，分别,2008年1月至2018年12月化疗被分层为氟嘧啶加铂与单独的氟嘧啶，含有替吉奥/吉马拉西/辛曲（S-1）的方案与不含S-1的方案相比，和S-1加顺铂与S-1单独。
结果：患者的中位年龄为67.0（范围24.6-98.8）岁。中位随访时间为105个月，32例（22.9%）和130例（50.8%）II期和III期患者复发，分别。68例（48.6%）和73例（28.5%）患者作为氟嘧啶单药治疗给予辅助化疗，氟嘧啶加铂对9例（6.4%）和104例（40.6%）患者，无63例(45.0%)和79例(30.9%)II期和III期胃癌患者，分别。Doublet化疗与更长的无病生存期（DFS）（26.5vs.15.2个月，P=0.001）和总生存期（OS）（41.2vs.22.0个月，P<0.001）比IIIB-IIIC期疾病的氟嘧啶单一疗法。此外，含S-1的方案延长了DFS（57.4vs.21.9个月，P=0.044）和OS（81.4vs.28.6个月,P=0.023）与III期疾病中不含S-1的化疗相比。
结论：尽管氟嘧啶单药治疗II-IIIA期疾病是可行的，对于IIIB-IIIC期疾病,双重化疗与单药治疗相比具有更长的生存期显著相关.在III期胃癌中，与不含S-1的化疗相比，含S-1的方案可能导致更长的生存期。
方法：我们回顾性分析了辅助化疗对140和256例II期和III期胃癌患者预后的影响，分别,2008年1月至2018年12月化疗被分层为氟嘧啶加铂与单独的氟嘧啶，含有替吉奥/吉马拉西/辛曲（S-1）的方案与不含S-1的方案相比，和S-1加顺铂与S-1单独。
结果：患者的中位年龄为67.0（范围24.6-98.8）岁。中位随访时间为105个月，32例（22.9%）和130例（50.8%）II期和III期患者复发，分别。68例（48.6%）和73例（28.5%）患者作为氟嘧啶单药治疗给予辅助化疗，氟嘧啶加铂对9例（6.4%）和104例（40.6%）患者，无63例(45.0%)和79例(30.9%)II期和III期胃癌患者，分别。Doublet化疗与更长的无病生存期（DFS）（26.5vs.15.2个月，P=0.001）和总生存期（OS）（41.2vs.22.0个月，P<0.001）比IIIB-IIIC期疾病的氟嘧啶单一疗法。此外，含S-1的方案延长了DFS（57.4vs.21.9个月，P=0.044）和OS（81.4vs.28.6个月,P=0.023）与III期疾病中不含S-1的化疗相比。
结论：尽管氟嘧啶单药治疗II-IIIA期疾病是可行的，对于IIIB-IIIC期疾病,双重化疗与单药治疗相比具有更长的生存期显著相关.在III期胃癌中，与不含S-1的化疗相比，含S-1的方案可能导致更长的生存期。
