The Efficacy of Taxanes- and Oxaliplatin-Based Chemotherapy in the Treatment of Gastric Cancer After D2 Gastrectomy for Different Lauren Types

Abstract

To investigate the efficacy of Taxanes- and Oxaliplatin-based chemotherapies (TC and OC) in the treatment of gastric cancer patients after D2 gastrectomy with different Lauren types. In this study, 299 patients of gastric adenocarcinoma with D2 lymph node dissection were reviewed between 2007 and 2014. Chemotherapies were classified as Oxaliplatin-based and Taxanes-based regimen. Treatment outcomes were analyzed according to different Lauren types, such as the intestinal type, diffuse type, and mixed type groups, respectively. The disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan–Meier method. The log-rank test was used for univariate analysis, and Cox regression was used for multivariate analysis. In diffuse type gastric cancer, the Oxaliplatin-based arm had a longer median DFS and OS compared with Taxanes-based arm (DFS: 47.0 vs 28.6 months, P = 0.04; OS: 51.9 vs 34.5 months, P = 0.048). The chemotherapy regimen was an independent prognostic factor for DFS and OS of diffuse type gastric cancer patients by multivariate analysis (P = 0.01). In the intestinal type, although the DFS and OS of intestinal type patients in TC group were higher than those in OC group (DFS: 53.4 vs 42.4 months; OS: 69.7 vs 57.8 months), there was no statistical significance observed (both P > 0.05). For the mixed type, the 2 different chemotherapy regimens achieved similar median DFS and OS. In a conclusion, the patients of diffuse type were more sensitive to OC, and the intestinal type patients may be benefit from TC. Therefore, it will be of benefit for gastric patients by introducing Lauren classification clinically and to help the choice of chemotherapy regimen for gastric patients after D2 gastrectomy.

The role of oxaliplatin in the adjuvant setting of different Lauren’s type of gastric adenocarcinoma after D2 gastrectomy: a real-world study

“…Nevertheless, there has been conflicting result reported that in diffuse type gastric cancer; patients in the oxaliplatin-based chemotherapy group had a longer median DFS (47.0 months vs. 28.6 months, P = 0.04) and OS (51.9 months vs. 34.5 months, P = 0.048) compared with those in taxane-based chemotherapy group [22]. We believed that the possible reasons for these conflicting results might be the selection of enrolled patients and different adjuvant chemotherapy regimens.…”

Taxane‐based versus platinum‐based chemotherapy in early recurrent gastric cancer after radical surgery with S‐1 adjuvant chemotherapy: A multi‐institutional retrospective analysis

“…A previous study on adjuvant chemotherapy showed that a diffuse histological type might benefit from oxaliplatin-based chemotherapy, whereas an intestinal histological type might benefit from taxanebased chemotherapy. 16 A recent retrospective study showed that the overall response rate of PB regimens was higher than TB regimens, although this difference was not statistically significant. 8 XParTS-1 trial revealed safety, high response rate, and efficacy of XP.…”

“…Although OS was not significantly differentiated in each group, the risk factor of undifferentiated type was second‐line TB chemotherapy. A previous study on adjuvant chemotherapy showed that a diffuse histological type might benefit from oxaliplatin‐based chemotherapy, whereas an intestinal histological type might benefit from taxane‐based chemotherapy 16 . A recent retrospective study showed that the overall response rate of PB regimens was higher than TB regimens, although this difference was not statistically significant 8 .…”

Evaluation of Multislice Spiral Computed Tomography Perfusion Imaging for the Efficacy of Preoperative Concurrent Chemoradiotherapy in Middle-aged and Elderly Patients with Locally Advanced Gastric Cancer

“…Histological types of GC mainly include the intestinal type of well-differentiated tubular and papillary adenocarcinoma, and the diffused type of low-differentiated adenocarcinoma and signet ring cell carcinoma [ 22 ]. It has been demonstrated that GC of different histological types responded differently to therapies and hence resulting in different outcomes [ 23 ]. The results of this study demonstrated that perfusion parameters were important indicators for LNM, tumor differentiation, and histological type in LAGC patients.…”