Total gastrectomy increases the incidence of grade III and IV toxicities in patients with gastric cancer receiving adjuv
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Total gastrectomy increases the incidence of grade III and IV toxicities in patients with gastric cancer receiving adjuvant TS-1 treatment Wen-Chi Chou1†, Chia-Lun Chang1†, Keng-Hao Liu2, Jun-Te Hsu2, Hung-Chih Hsu1, Wen-Chi Shen1, Yu-Shin Hung1 and Jen-Shi Chen1* A correction to this article has been published: http://www.wjso.com/content/11/1/310
Abstract Background: We aimed to evaluate the safety and efficacy of TS-1 adjuvant chemotherapy in Taiwanese patients with gastric cancer. Methods: We included in this study patients with locally advanced gastric cancer who received adjuvant TS-1 or 5-fluorouracil chemotherapy after curative surgery and extended lymph node dissection between 1 June 2008 and 31 December 2012 at Chang Gung Memorial Hospital. Patient characteristics, tumor features, safety profiles and compliance with TS-1 treatment were retrospectively analyzed from medical charts. Results: Forty patients received adjuvant chemotherapy with TS-1 and 193 with 5-fluorouracil within the study period. The 1- and 2-year overall survival rates were 90.6% and 87% in the TS-1 group and 95.4% and 86.8% in the 5-fluorouracil group (P = 0.34). The 1- and 2-year disease-free survival rates were 90.6% and 74.7% in the TS-1 group and 88% and 75.7% in the 5-fluorouracil group (P = 0.66). In the TS-1 group, tumor recurrence was more frequent in those with >15 metastatic lymph nodes than ≤15. Overall, 78.9%, 74.3%, 62.1% and 56% of patients underwent TS-1 treatment for at least 3, 6, 9 and 12 months, respectively. The most common adverse events of TS-1 were skin hyperpigmentation (55%), diarrhea (27.5%), dizziness (27.5%) and leucopenia (20%). Severe adverse events (SAEs; grade III or IV toxicity) were diarrhea (7.5%), stomatitis (7.5%), leukopenia (5%), vomiting (2.5%), anorexia (2.5%) and dizziness (2.5%). Patients who underwent total gastrectomy had a significantly greater risk of TS-1-related SAEs than patients who underwent subtotal gastrectomy (40% versus 8%, P = 0.014). Conclusions: The incidence of SAEs during TS-1 therapy was more common in Taiwanese patients with gastric cancer who underwent total gastrectomy compared with those who underwent subtotal gastrectomy. Clinicians must be aware of and able to manage these SAEs to maximize patient compliance with adjuvant TS-1. Keywords: Adjuvant chemotherapy, Compliance, Gastric cancer, Safety profile, TS-1
Background Gastric cancer is the fourth most common cancer and the second most common cause of cancer death worldwide. In 2008, there were an estimated 989,600 new gastric cancer cases and 738,000 deaths worldwide [1]. In Taiwan,
* Correspondence: [email protected] † Equal contributors 1 Division of Hematology-Oncology, Department of Internal Medicine, No. 5 Fuxing Street, Guishan Township, Taoyuan County 333, Taiwan ROC Full list of author information is available at the end of the article
gastric cancer is the sixth leading cause of cancer-related mortality, causing approximately 2,446 patient dea
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