Chonnam Med J.  2018 Sep;54(3):173-177. 10.4068/cmj.2018.54.3.173.

The Predictive Value of Epstein-Barr Virus-Positivity in Patients Undergoing Gastrectomy Followed by Adjuvant Chemotherapy

• Baek DW
• Kang BW
• Kim JG

• KMID: 2420885
• DOI: http://doi.org/10.4068/cmj.2018.54.3.173

Abstract

The present study evaluated the survival impact of standard adjuvant chemotherapy and prognostic differences between Epstein-Barr virus (EBV)-associated gastric cancer (EBVaGC) and EBV-negative gastric cancer (EBVnGC). A total of 276 patients were enrolled according to the following criteria: 1) pathologically diagnosed with primary gastric adenocarcinoma, 2) test results from EBV-encoded RNA in situ hybridization, 3) stage II/III according to the 7th edition of UICC/AJCC staging system for gastric cancer, and 4) postoperative adjuvant chemotherapy. Fifty-nine (21.4%) and 217 (78.6%) patients exhibited EBVaGC and EBVnGC, respectively, while 129 (46.7%) patients were classified as stage II and 147 (53.3%) as stage III. As for adjuvant chemotherapy, 87 (31.5%) patients received capecitabine and oxaliplatin, while 189 (68.5%) received S-1 monotherapy. With a median follow-up duration of 21.3 (6.4-89.0) months, the estimated 3-year disease-free survival (DFS) and overall survival (OS) rates were 74.8% and 83.0%, respectively. In univariate analysis and multivariate analysis using a Cox proportional hazard model including age, gender, stage, Lauren classification, and the type of chemotherapy, EBV-positivity was not significantly associated with DFS (p-value= 0.630) regardless of the type of chemotherapy. Therefore, no association was found between EBV positivity and the survival outcomes in patients with curatively resected gastric cancer who received standard adjuvant chemotherapy.

Keyword

Epstein-Barr Virus Infections; Stomach Neoplasms; Chemotherapy, Adjuvant; Survival Rate

MeSH Terms

Adenocarcinoma
Capecitabine
Chemotherapy, Adjuvant*
Classification
Disease-Free Survival
Drug Therapy
Epstein-Barr Virus Infections
Follow-Up Studies
Gastrectomy*
Herpesvirus 4, Human
Humans
In Situ Hybridization
Multivariate Analysis
Proportional Hazards Models
RNA
Stomach Neoplasms
Survival Rate
Capecitabine
RNA

Figure

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  FIG. 1 Kaplan-Meier survival curves for disease-free survival according to (A) EBV-positivity, (B) EBV-positivity in XELOX group, (C) EBV-positivity in S-1 group.

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