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Timing and site-specific trends of recurrence in patients with pathological stage II or III gastric cancer after curative gastrectomy followed by adjuvant S-1 monotherapy

  • Ryo Takahashi
  • Manabu OhashiEmail author
  • Yosuke Kano
  • Satoshi Ida
  • Koshi Kumagai
  • Souya Nunobe
  • Keisho Chin
  • Kensei Yamaguchi
  • Masato Nagino
  • Takeshi Sano
  • Naoki Hiki
Original Article
  • 68 Downloads

Abstract

Background

Adjuvant S-1 monotherapy prolongs the survival of patients with pathological stage II or III gastric cancer undergoing D2 gastrectomy. This therapeutic regimen is standard in Japan. Unfortunately, some patients who undergo this treatment suffer from recurrent disease. However, information regarding the timing and site-specific trends of recurrence is insufficient.

Methods

Among 396 patients who underwent D2 gastrectomy followed by adjuvant S-1 monotherapy between 2008 and 2012, 122 experienced a recurrence. We retrospectively determined the timing and sites of recurrence.

Results

The median RFS of the 122 patients was 19.5 months, and their 1-, 3- and 5-year RFS rates were 67.2%, 23.0% and 5.7%, respectively. There were no significant differences in RFS among disease substages. Local recurrence, lymph node involvement and peritoneal and hematogenous metastases were found in 6, 25, 63 and 42 patients, respectively. Approximately 10% of patients presented with contemporaneous sites of recurrence. Local recurrence and lymph node metastasis plateaued 3 years after gastrectomy. Peritoneal and hematogenous metastasis increased within 5 years after surgery. In patients with hematogenous metastasis, the number of liver metastases plateaued but increased in others.

Conclusions

In patients with recurrent disease who underwent D2 gastrectomy followed by adjuvant S-1 monotherapy, 80% of recurrences occur within 3 years after gastrectomy. The timing of recurrence is not significantly different among substages. Although the rates of local recurrence and lymph node and liver metastasis plateau after 3 years, peritoneal and the other hematogenous metastases increase within 5 years.

Keyword

Gastric cancer S-1 Adjuvant chemotherapy Recurrence Timing Site-specific trends 

Notes

Acknowledgements

Dr. Daisuke Takahari, Dr. Takashi Ichimura, Dr. Mariko Ogura and Dr. Takeru Wakatsuki of the Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research treated the patients, and we thank them for collecting data.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical standards

All procedures were conducted in accordance with the ethical standards of institutional and national committees responsible for human experimentation and with the 1964 and later versions of the Declaration of Helsinki.

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019

Authors and Affiliations

  • Ryo Takahashi
    • 1
    • 2
  • Manabu Ohashi
    • 1
    Email author
  • Yosuke Kano
    • 1
  • Satoshi Ida
    • 1
  • Koshi Kumagai
    • 1
  • Souya Nunobe
    • 1
  • Keisho Chin
    • 1
  • Kensei Yamaguchi
    • 1
  • Masato Nagino
    • 2
  • Takeshi Sano
    • 1
  • Naoki Hiki
    • 1
  1. 1.Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of MedicineNagoyaJapan

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