Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer

Hyung Soon Park; Minkyu Jung; Hyo Song Kim; Hyoung Il Kim; Ji Yeong An; Jae Ho Cheong; Woo Jin Hyung; Sung Hoon Noh; Yong Il Kim; Hyun Cheol Chung; Sun Young Rha

doi:10.1245/s10434-014-3949-2

Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer

Hyung Soon Park, Minkyu Jung, Hyo Song Kim, Hyoung Il Kim, Ji Yeong An, Jae Ho Cheong, Woo Jin Hyung, Sung Hoon Noh, Yong Il Kim, Hyun Cheol Chung, Sun Young Rha

Research output: Contribution to journal › Article › peer-review

44 Citations (Scopus)

Abstract

Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.

Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.

Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4–8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037).

Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.

Original language	English
Pages (from-to)	224-231
Number of pages	8
Journal	Annals of surgical oncology
Volume	22
Issue number	1
DOIs	https://doi.org/10.1245/s10434-014-3949-2
Publication status	Published - 2015

Bibliographical note

Funding Information:
Dr. S.Y. Rha’s research was supported by the Public Welfare & Safety Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2010-0020841). Dr. M. Jung’s research was supported by a grant from the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A101232). We thank Han Na Park (Cancer Metastasis Research Center, Yonsei University College of Medicine) for her help with data collection. Hyung Soon Park, MD and Minkyu Jung, MD, contributed equally to this work as first authors.

Publisher Copyright:
© 2014, Society of Surgical Oncology.

All Science Journal Classification (ASJC) codes

Surgery
Oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1245/s10434-014-3949-2

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title = "Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer",

abstract = "Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4–8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037).Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.",

author = "Park, {Hyung Soon} and Minkyu Jung and Kim, {Hyo Song} and Kim, {Hyoung Il} and An, {Ji Yeong} and Cheong, {Jae Ho} and Hyung, {Woo Jin} and Noh, {Sung Hoon} and Kim, {Yong Il} and Chung, {Hyun Cheol} and Rha, {Sun Young}",

note = "Funding Information: Dr. S.Y. Rha{\textquoteright}s research was supported by the Public Welfare & Safety Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2010-0020841). Dr. M. Jung{\textquoteright}s research was supported by a grant from the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A101232). We thank Han Na Park (Cancer Metastasis Research Center, Yonsei University College of Medicine) for her help with data collection. Hyung Soon Park, MD and Minkyu Jung, MD, contributed equally to this work as first authors. Publisher Copyright: {\textcopyright} 2014, Society of Surgical Oncology.",

year = "2015",

doi = "10.1245/s10434-014-3949-2",

language = "English",

volume = "22",

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T1 - Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer

AU - Park, Hyung Soon

AU - Jung, Minkyu

AU - Kim, Hyo Song

AU - Kim, Hyoung Il

AU - An, Ji Yeong

AU - Cheong, Jae Ho

AU - Hyung, Woo Jin

AU - Noh, Sung Hoon

AU - Kim, Yong Il

AU - Chung, Hyun Cheol

AU - Rha, Sun Young

N1 - Funding Information: Dr. S.Y. Rha’s research was supported by the Public Welfare & Safety Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2010-0020841). Dr. M. Jung’s research was supported by a grant from the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A101232). We thank Han Na Park (Cancer Metastasis Research Center, Yonsei University College of Medicine) for her help with data collection. Hyung Soon Park, MD and Minkyu Jung, MD, contributed equally to this work as first authors. Publisher Copyright: © 2014, Society of Surgical Oncology.

PY - 2015

Y1 - 2015

N2 - Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4–8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037).Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.

AB - Background: Adjuvant chemotherapy improves survival in patients with gastric cancer. However, the relationship between the timing of adjuvant chemotherapy and survival has not been investigated.Methods: Patients with D2-resected stage 2 and 3 gastric cancer that received adjuvant chemotherapy from 2005 to 2011 at Yonsei University Health System were included. The patients were grouped according to intervals between surgery and adjuvant chemotherapy.Results: Among 840 patients, the interval from surgery to the start of adjuvant therapy was less than 4 weeks in 337 (40.1 %) patients (early group), 4–8 weeks in 467 (55.6 %) patients (intermediate group), and more than 8 weeks in 36 (4.3 %) patients (late group). The 5-year RFS was 55.7 % in the early group, 54.4 % in the intermediate group, and 43.6 % in the late group (p = 0.076). The corresponding 5-year OS rates were 63.4, 62.8, and 51.7 % (p = 0.037).Conclusions: There is insufficient evidence to suggest starting adjuvant chemotherapy within 4 weeks after surgery for patients with D2 resected stage 2 and 3 gastric cancer. However, delayed treatment of adjuvant chemotherapy after 8 weeks showed worse survival outcomes than early and intermediate treatment initiation, suggesting that adjuvant chemotherapy should be considered start within 8 weeks after radical resection.

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SN - 1068-9265

VL - 22

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EP - 231

JO - Annals of surgical oncology

JF - Annals of surgical oncology

IS - 1

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Proper Timing of Adjuvant Chemotherapy Affects Survival in Patients with Stage 2 and 3 Gastric Cancer

Abstract

Bibliographical note

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