논문검색
Author Tae Kyung Ha, M.D.Min Sung Jung, M.D.Kang Hong Lee, M.D.Kyeong Geun Lee, M.D.Sung Joon Kwon, M.D.
Place of duty Department of Surgery, HanyangUniversity College of Medicine, Seoul, Korea
Title The Effect of Adjuvant Chemotherapy on Stage Ⅳ(T4N1-3M0 and T1-3N3M0) Gastric Cancer
Publicationinfo Cancer Res Treat 2009 Mar; 041(01): 19-23.
Key_word Adjuvant chemotherapy, Stage Ⅳgastric cancer, Curative gastrectomy,survival
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Abstract PurposeThe optimal chemotherapeutic strategy for gastric cancer patients has not beendetermined, especially with respect to stage and the curability of gastric cancer. The aim ofthis study was to evaluate the results of adjuvant chemotherapy on stage Ⅳ(T4N1-3M0 andT1-3N3M0) gastric cancer after curative gastrectomy between a chemotherapy (CTX) groupand non-chemotherapy (non-CTX) group. Materials and Methods Among 1,760 patients who underwent gastric surgery by 1 surgeon in a single institution, 162stage Ⅳgastric cancer patients with curative gastrectomy were analyzed retrospectively,excluding patients with TanyNanyM1. One hundred twenty-five patients who receiveddifferent chemotherapeutic regimens were compared to 37 patients who did not receivechemotherapy for reasons of old age or according to their expressed desire. ResultsThe clinicopathologic factors which showed a clinically significant difference between thetwo groups were age and histology, which were not associated with patient survival. TheCTX group was younger, and had a larger proportion of undifferentiated gastric cancersthan the non-CTX group. The mode of treatment failure revealed no significant differencebetween the CTX and non-CTX groups. The 1, 3, and 5-year disease-free survival and the 1,3, and 5-year disease-specific survival of the CTX group were 63.9%, 38.4%, and 32.0%, and85.4%, 52.3%, and 39.6%, respectively, which were more favorable than the non-CTX group(p=0.015 and p=0.001, respectively). Postoperative adjuvant CTX was an independent riskfactor for disease-specific survival of stage Ⅳ(T4N1-3M0 and T1-3N3M0) gastric cancerpatients after curative gastrectomy by multivariate analysis (odds ratio=2.153; 95%confidence interval=1.349-3.435; p=0.001). ConclusionsAdjuvant CTX may be associated with survival benefit for younger patients with stage Ⅳ(T4N1-3M0 and T1-3N3M0) gastric cancer with undifferentiated histology after curativegastrectomy. A randomized controlled trial to reveal the effect of stage-specific adjuvantchemotherapy should be conducted.
출판정보 대한암학회지 2009 Mar; 041(01): 19-23.