Annals of surgical oncology · 2025
Survival Benefit of Adjuvant S-1 Chemotherapy in Patients Aged ≥ 80 Years with Gastric Cancer after Curative Resection: A Multicenter Cohort Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Sumiyoshi Shutaro, Kubota Takeshi, Inoue Hiroyuki, Takabatake Kazuya, Nishibeppu Keiji, Hamada Junichi, Ochiai Toshiya, Ariyoshi Yosuke, Toma Atsushi, Watanabe Kenji, Yamaoka Nobuki, Sai Soujin, Ide Shozo, Hatakeyama Tomoya, Itokawa Yoshiki, Ochi Fumiaki, Konishi Hirotaka, Fujiwara Hitoshi, Sekimoto Miho, Shikata Satoru, Shiozaki Atsushi
Аннотация
BACKGROUND: The efficacy of adjuvant chemotherapy for gastric cancer (GC) in adult patients aged ≥ 80 years remains unclear because this population is often underrepresented in clinical trials. This study aimed to evaluate the impact of S-1 adjuvant chemotherapy on this age group following curative gastrectomy.
PATIENTS AND METHODS: This retrospective multicenter study included 113 patients aged ≥ 80 years with pathological stage II/III GC who underwent curative D2 or D1+ gastrectomy between 2008 and 2020. Patients were classified according to whether they had received S-1 adjuvant chemotherapy. Overall survival (OS), recurrence-free survival (RFS), adverse events, and relative dose intensity (RDI) were analyzed.
RESULTS: Among the patients, 30 received S-1 and 83 underwent surgery alone. Baseline characteristics were generally balanced, although the S-1 group had a higher rate of D2 dissection and shorter postoperative hospital stays. The 5-year OS and RFS rates were significantly higher in the S-1 group (70.0% and 66.7%, respectively) than in the nonchemotherapy group (48.1% and 45.7%, respectively). Multivariable analysis confirmed S-1 administration as an independent prognostic factor for both OS and RFS. Grade ≥ 3 adverse events occurred in 22.3% of patients who received S-1. Patients who maintained an RDI ≥ 60% demonstrated improved RFS.
CONCLUSIONS: Adjuvant chemotherapy with S-1 may improve survival in patients aged ≥ 80 years with stage II/III GC. Maintaining an adequate dose intensity appears to be critical for clinical benefits in this population.
PATIENTS AND METHODS: This retrospective multicenter study included 113 patients aged ≥ 80 years with pathological stage II/III GC who underwent curative D2 or D1+ gastrectomy between 2008 and 2020. Patients were classified according to whether they had received S-1 adjuvant chemotherapy. Overall survival (OS), recurrence-free survival (RFS), adverse events, and relative dose intensity (RDI) were analyzed.
RESULTS: Among the patients, 30 received S-1 and 83 underwent surgery alone. Baseline characteristics were generally balanced, although the S-1 group had a higher rate of D2 dissection and shorter postoperative hospital stays. The 5-year OS and RFS rates were significantly higher in the S-1 group (70.0% and 66.7%, respectively) than in the nonchemotherapy group (48.1% and 45.7%, respectively). Multivariable analysis confirmed S-1 administration as an independent prognostic factor for both OS and RFS. Grade ≥ 3 adverse events occurred in 22.3% of patients who received S-1. Patients who maintained an RDI ≥ 60% demonstrated improved RFS.
CONCLUSIONS: Adjuvant chemotherapy with S-1 may improve survival in patients aged ≥ 80 years with stage II/III GC. Maintaining an adequate dose intensity appears to be critical for clinical benefits in this population.