Loss of Lean Body Mass as an Independent Risk Factor for Continuation of S-1 Adjuvant Chemotherapy for Gastric Cancer
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Background and Aims
Compliance with S-1 adjuvant chemotherapy is not satisfactory, and the aim of the present study was to clarify risk factors for the continuation of S-1 after gastrectomy.
This retrospective study selected patients who underwent curative D2 surgery for gastric cancer, were diagnosed with stage II/III disease, had a creatinine clearance >60 ml/min, and received adjuvant S-1 at our institution between June 2010 and March 2014. The time to S-1 treatment failure (TTF) was calculated.
Fifty-eight patients were selected for the present study. When the TTF curves stratified by each clinical factor were compared using the log-rank test, lean body-mass loss (LBL) of 5 % was regarded as a critical cutoff point. Univariate Cox’s proportional hazard analyses demonstrated that LBL was a significant independent risk factor for continuation. The 6-month continuation rate was 91.7 % in patients with an LBL < 5 %, and 66.3 % for patients with an LBL > 5 % (p = 0.031).
The present study demonstrated that LBL might be an important risk factor for a decrease in compliance to adjuvant chemotherapy with S-1 in patients with stage II/III gastric cancer who underwent D2 gastrectomy. A multicenter, double-blinded, prospective cohort study is necessary to confirm whether LBL would affect adjuvant S-1 continuation.
KeywordsGastric Cancer Adjuvant Chemotherapy Lean Body Mass Subcutaneous Adipose Tissue Enhance Recovery After Surgery
This work was supported in part by a non-governmental organization, the Kanagawa Standard Anti-Cancer Therapy Support System. The authors express their sincere gratitude to Mrs. Rika Takahashi for her excellent data management.
Toru Aoyama, Taiichi Kawabe, Hirohito Fujikawa, Tsutomu Hayashi, Takanobu Yamada, Kazuhito Tsuchida, Norio Yukawa, Takashi Oshima, Yasushi Rino, Munetaka Masuda, Takashi Ogata, Haruhiko Cho, and Takaki Yoshikawa declare no conflicts of interest.