Exploratory Analysis to Find Unfavorable Subset of Stage II Gastric Cancer for Which Surgery Alone Is the Standard Treatment; Another Target for Adjuvant Chemotherapy

Abstract

The aim of the present study was to explore the unfavorable subset of patients with Stage II gastric cancer for whom surgery alone is the standard treatment (T1N2M0, T1N3M0, and T3N0M0). Recurrence-free survival rates were examined in 52 patients with stage T1N2-3M0 and stage T3N0M0 gastric cancer between January 2000 and March 2010. Univariate and multivariate analyses were performed to identify risk factors using a Cox proportional hazards model. The recurrence-free survival (RFS) rates of the patients with stages T1N2, T1N3, and T3N0 cancer were 80.0, 76.4, and 100% at 5 years, respectively. The only significant prognostic factor for the survival rates of the patients with stage pT1N2-3 cancer measured by univariate and multivariate analyses was pathological tumor diameter. The 5-year RFS rates of the patients with stage pT1N2-3 cancer were 60.0%, when the tumor diameters measured ,30 mm, and 88.9% when the tumor diameters measured .30 mm (P ¼ 0.0248). These data may suggest that pathological tumor diameter is associated with poor survival in patients with small T1N2-3 tumors. Because our study was a retrospective single-center study with a small sample size, a prospective multicenter study is necessary to confirm whether small tumors are risk factor for the RFS in T1N2-3 disease.

Evaluation of the prognostic factors in patients with pT3N0 or pT1N2–3 gastric cancer: a single institutional retrospective cohort study

“…Toyokawa et al conducted a retrospective study of 201 patients with stage IB gastric cancer according to second JCGC (T2N0, T3N0, and T1N1-3 according to third JCGC), and concluded that large tumors might be candidates for adjuvant chemotherapy [12]. Aoyama et al retrospectively examined 52 patients with pathological stage II according to third JCGC (T1N2-3, T3N0), and identified small tumor diameter as an independent prognostic factor in patients with T1N2-3 [13]. Due to the limited sample sizes, it may not be possible to reach a consistent conclusion.…”

Advances in targeted therapy for human epidermal growth factor receptor 2 positive in advanced gastric cancer

“…The CheckMate 649 study established the important position of ICI in the immunotherapy of advanced gastric cancer. The latest research results were updated at the European Society of Medical Oncology Congress in 2022, which further confirmed the effect of nebuliuzumab combined with chemotherapy in the whole population, and the ORR of all randomized patients increased from 46% to 58%[ 188 - 190 ]. Both PFS and OS are extended and secure.…”