J Gastric Cancer.
2022 Mar;22(1):67-77. 10.5230/jgc.2022.22.e6.
Long-Term Survival Outcomes of Elderly Patients Treated With S-1 or Capecitabine Plus Oxaliplatin for Stage II or III Gastric Cancer: A Multicenter Cohort Study
- Choi S
1 - Min JS2
- Jeong SH3
- Yoo MW4
- Son YG5
- Oh SJ6
- Kim JH7
- Park JM8
- Hur H9
- Jee YS10
- Hwang SH11
- Jin SH12
- Lee SE13
- Lee YJ3
- Seo KW14
- Park S7
- Lee CM7
- Kim CH15
- Jeong IH16
- Lee HH17
- Choi SI18
- Lee SI19
- Kim CY20
- Chae H21
- Son MW22
- Pak KH23
- Kim S16
- Lee MS24
- Kim HI25
- Affiliations
-
- 1Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
- 2Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Cancer Center, Busan, Korea
- 3Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
- 4Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 5Department of Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
- 6Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
- 7Department of Surgery, Korea University College of Medicine, Seoul, Korea
- 8Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
- 9Department of Surgery, Ajou University School of Medicine, Suwon, Korea
- 10Department of Surgery, Dankook University Hospital, Cheonan, Korea
- 11Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
- 12Department of Surgery, Korea Cancer Center Hospital, Seoul, Korea
- 13Department of Surgery, Konyang University Hospital, Daejeon, Korea
- 14Department of Surgery, Kosin University College of Medicine, Busan, Korea
- 15Department of Surgery, G Sam Hospital, Gunpo, Korea
- 16Department of Surgery, Jeju National University Hospital, Jeju, Korea
- 17Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 18Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- 19Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea
- 20Department of Surgery, Jeonbuk National University College of Medicine, Jeonju, Korea
- 21Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Korea
- 22Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
- 23Department of Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
- 24Department of Surgery, Eulji University Hospital, Daejeon, Korea
- 25Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2535084
- DOI: http://doi.org/10.5230/jgc.2022.22.e6
Abstract
- Purpose
Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years.
Materials and Methods
Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group.
Results
Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072–3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550–5.692; P=0.001).
Conclusions
This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.
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