Impact of Postoperative Complications on Recurrence in Patients With Stage II/III Gastric Cancer Who Received Adjuvant Chemotherapy With S-1

Anticancer Res. 2020 Mar;40(3):1683-1690. doi: 10.21873/anticanres.14120.

Abstract

Background: This study aimed to investigate the impact of postoperative complications (PCs) in patients with pathological stage (pStage) II or III gastric cancer (GC) who received adjuvant chemotherapy with S-1 after curative surgery.

Patients and methods: Altogether, data for 226 patients were examined retrospectively. The relationship between PCs and clinicopathological features and survival were examined.

Results: Recurrence-free survival was significantly worse in the group with PCs than in the PC-negative group. On multivariate analysis, having PCs of grade 2 or more was an independent risk factor for recurrence (hazard ratio=1.721; 95% confidence intervaI=1.014-2.920; p=0.044). In addition, for each pStage analysis, having PCs of grade 2 or more was a risk factor for recurrence even in patients with pStage II GC.

Conclusion: PC of grade 2 or more was an independent risk factor for recurrence in patients with pStage II GC who received adjuvant chemotherapy with S-1 after curative gastrectomy. Thus, for patients with PCs, even for those with pStage II GC, more effective adjuvant chemotherapy, such as S-1 plus docetaxel, may be needed.

Keywords: Gastric cancer; adjuvant chemotherapy; postoperative complication; recurrence.

MeSH terms

  • Chemotherapy, Adjuvant
  • Drug Combinations
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Oxonic Acid / pharmacology
  • Oxonic Acid / therapeutic use*
  • Postoperative Complications
  • Prognosis
  • Stomach Neoplasms / complications*
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Tegafur / pharmacology
  • Tegafur / therapeutic use*

Substances

  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid