Annals of Surgical Oncology

, Volume 25, Issue 5, pp 1176–1183 | Cite as

Efficacy of Adjuvant S-1 Versus XELOX Chemotherapy for Patients with Gastric Cancer After D2 Lymph Node Dissection: A Retrospective, Multi-Center Observational Study

  • In-Hwan Kim
  • Sung-Soo Park
  • Chang-Min Lee
  • Min Chan Kim
  • In-Kyu Kwon
  • Jae-Seok Min
  • Hyoung-Il Kim
  • Han Hong Lee
  • Sang-Il Lee
  • Hyundong Chae
Gastrointestinal Oncology



After curative resection of gastric cancer with D2 lymph node dissection, postoperative adjuvant chemotherapy with S-1 or capecitabine plus oxaliplatin (XELOX) is considered to be standard therapy in Eastern countries. This study aimed to compare the efficacies of adjuvant S-1 and XELOX chemotherapy for gastric cancer patients after D2 dissection based on disease-free survival (DFS).


This retrospective observational study was conducted at 29 tertiary hospitals in Korea. Of 1898 patients who underwent curative resection and received adjuvant chemotherapy for gastric cancer between February 2012 and December 2013, 1088 patients who met the eligibility criteria were enrolled in the study. After propensity score-matching, the 3-year disease-free survival rate (DFS) was used to compare efficacies directly between adjuvant XELOX and S-1 chemotherapies for patients with stage 2 or 3 gastric cancer after D2 gastrectomy.


The 3-year DFS rates for the S-1 and XELOX groups did not differ significantly among disease stages 2A, 2B, and 3A (all p > 0.05). However, the survival rates for the S-1 group were significantly lower than for the XELOX group for stage 3B (65.8% vs. 68.6%; p = 0.019) and stage 3C (48.4% vs. 66.7%; p = 0.002) gastric cancer. The hazard ratios (HRs) of S-1 chemotherapy for recurrence compared with XELOX for stages 3B and 3C were respectively 2.030 [95% confidence interval (CI), 1.110–3.715; p = 0.022] and 2.732 (95% CI 1.427–5.234; p = 0.002).


Adjuvant XELOX chemotherapy was more effective than S-1 for patients with stage 3B or 3C gastric cancer after D2 lymph node dissection.



We especially thank Wan-Sik Yu, MD, Oh-Kyung Kwon, MD, Seung-Su Lee, MD, Sang-Eok Lee, MD, Young-Jun Lee, MD, Sang-Ho Jung, MD, Sung-Il Choi, MD, Seung-Wan Ryu, MD, Jong-Seok Kim, MD, Seong-Heum Park, MD, Jong-Han Kim, MD, Ye-Seob Ji, MD, Il-Myoung Kim, MD, Soon-Hwi Hwang, MD, Jun-Hyun Lee, MD, Do-Joog Park, MD, Moon-Won Yu, MD, Sang-Uk Han, MD, Yong-Kwan Jo, MD, Hang-Jong Yu, MD, Jong-In Lee, MD, Sung-Ho Jin, MD, Jin-Jo Kim, MD, Seung-Man Park, MD, Sung-Su Kim, MD, Joong-Min Park, MD, Min-Kyu Kim, MD, and all members of the Surgical Oncology Forum (SOF) of Korea for collaboration, discussion, and data-sharing for this study.


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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • In-Hwan Kim
    • 1
  • Sung-Soo Park
    • 2
  • Chang-Min Lee
    • 2
  • Min Chan Kim
    • 3
  • In-Kyu Kwon
    • 4
  • Jae-Seok Min
    • 5
  • Hyoung-Il Kim
    • 6
  • Han Hong Lee
    • 7
  • Sang-Il Lee
    • 8
  • Hyundong Chae
    • 1
  1. 1.Department of SurgeryDaegu Catholic University School of MedicineDaeguSouth Korea
  2. 2.Department of SurgeryKorea University College of Medicine and School of MedicineSeoulSouth Korea
  3. 3.Department of SurgeryDong-A University School of MedicineBusanSouth Korea
  4. 4.Department of SurgeryKeimyung University School of MedicineDaeguSouth Korea
  5. 5.Department of SurgeryDongnam Institute of Radiological and Medical SciencesBusanSouth Korea
  6. 6.Department of SurgeryYonsei University School of MedicineSeoulSouth Korea
  7. 7.Department of SurgerySeoul St. Mary’s HospitalSeoulSouth Korea
  8. 8.Department of SurgeryChungnam National University School of MedicineDaejeonSouth Korea

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