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Gastric Cancer. 2019 May;22(3):587-597. doi: 10.1007/s10120-018-0895-x. Epub 2018 Nov 13.

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

Author information

1
Department of Medical Oncology, Center of Evidence Based Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
2
Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
3
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
4
Department of Medical Oncology, Center of Evidence Based Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China. liutianshu1969@126.com.
5
Center of Evidence-Based Medicine, Fudan University, Shanghai, People's Republic of China. liutianshu1969@126.com.

Abstract

BACKGROUND:

To compare the efficacy of oxaliplatin-based and oxaliplatin-free adjuvant chemotherapies in patients with different Lauren type gastric cancers after D2 gastrectomy.

METHODS:

From our established gastric cancer database, patients with pathological stage II and III gastric cancer who received adjuvant chemotherapy after D2 gastrectomy at Zhongshan Hospital of Fudan University were analyzed. Patients who received different adjuvant chemotherapy regimens were divided into two subgroups: oxaliplatin-based and oxaliplatin-free subgroup. Clinical outcomes were analyzed according to pathological stage and different Lauren types.

RESULTS:

From Jan 2010 to June 2017, a total of 580 patients met all the eligibility criteria and were enrolled. The median DFS for all the patients was 24.37 months and the median OS was 56.70 months. In patients with intestinal type gastric cancer, the median DFS of the oxaliplatin-based subgroup was significantly longer than that of oxaliplatin-free subgroup (48.73 vs. 18.33 months, P < 0.001). The median OS was not reached in the oxaliplatin-based subgroup and 54.33 months in the oxaliplatin-free subgroup (P = 0.006). In patients with diffuse type gastric cancer, neither DFS nor OS differed significantly between two subgroups. In multivariate analysis, oxaliplatin-based adjuvant chemotherapy was independent positive predictor of DFS (HR 0.40; 95% CI 0.28-0.59; P < 0.001) and OS (HR 0.35; 95% CI 0.20-0.62; P < 0.001) in patients with intestinal type gastric cancer.

CONCLUSIONS:

The results of our study suggested that oxaliplatin-based adjuvant chemotherapy was more effective in patients with intestinal type gastric cancer after D2 gastrectomy but showed no more survival benefit in patients with diffuse type.

KEYWORDS:

Adjuvant chemotherapy; Lauren type; Oxaliplatin

PMID:
30426294
DOI:
10.1007/s10120-018-0895-x

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