Format

Send to

Choose Destination
Gastric Cancer. 2019 Sep 12. doi: 10.1007/s10120-019-01007-w. [Epub ahead of print]

Long-term outcomes of preoperative docetaxel with cisplatin plus S-1 therapy for gastric cancer with extensive nodal metastasis (JCOG1002).

Author information

1
Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. daisuke.takahari@jfcr.or.jp.
2
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
3
Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
4
Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
5
Division of Upper Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
6
Division of Gastric Surgery, National Cancer Center Hospital, Tokyo, Japan.
7
Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
8
Department of Surgery, Gifu Municipal Hospital, Gifu, Japan.
9
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
10
Department of Surgery, Sakai City Medical Center, Sakai, Japan.
11
Division of Gastroenterology, Department of Internal Medicine, Kobe University School of Medicine, Kobe, Japan.
12
Department of Gastroenterological Surgery, Tenri Hospital, Tenri, Japan.
13
Department of Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research Cancer Institute Hospital, Tokyo, Japan.

Abstract

BACKGROUND:

Preoperative chemotherapy with cisplatin plus S-1 (CS) followed by gastrectomy with D2 plus para-aortic lymph node (PAN) dissection is regarded as a standard treatment in Japan for advanced gastric cancer with bulky lymph node (BN) and/or PAN metastasis. In the JCOG1002, we added docetaxel to CS (DCS) to further improve long-term outcomes. However, the primary endpoint, clinical response rate (RR), did not reach the expected level (Ito et al. in Gastric Cancer 20:322-31, 2017). Herein, we report our long-term survival results.

METHODS:

Patients with BN and/or PAN metastasis received 2 or 3 cycles of DCS therapy (docetaxel at 40 mg/m2 and cisplatin at 60 mg/m2 on day 1 and S-1 at 80 mg/m2 per day for 2 weeks, followed by a 2-week rest) followed by gastrectomy with D2 plus PAN dissection and postoperative S-1 for 1 year.

RESULTS:

Between July 2011 and May 2013, 53 patients were enrolled. Clinically, 17.0% had both PAN and BN metastasis, and the rest had either PAN (26.4%) or BN (56.6%) metastasis. Among all eligible patients, the 5-year overall survival was 54.9% (95% confidence interval 40.3-67.3%) at the last follow-up in May 2018. Among 44 eligible patients with R0 resection, the 5-year relapse-free survival was 47.7% (95% confidence interval 32.5-61.5%).

CONCLUSIONS:

Adding docetaxel to CS in preoperative chemotherapy for extensive nodal metastasis improved neither short-term outcomes nor long-term survival. Preoperative chemotherapy with CS followed by D2 + PAN dissection and postoperative S-1 remains the standard of care for patients with extensive nodal metastasis.

KEYWORDS:

DCS; Extensive lymph node metastasis; Gastric cancer; Preoperative chemotherapy

PMID:
31515693
DOI:
10.1007/s10120-019-01007-w

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center