J Cancer 2016; 7(12):1711-1715. doi:10.7150/jca.15598

Research Paper

Factors Influencing Clinicians' Choice of Adjuvant S-1 versus Capecitabine plus Oxaliplatin after Curative Gastrectomy in Patients with Gastric Cancer

Ha Yeon Lee1, In Gyu Hwang2✉, Song-Ee Park2, Moon Jin Kim3, Se Hoon Park4, Jung Hun Kang5, Young Saing Kim6, Sung Yong Oh7, Young-Woong Won8, Soon Il Lee9, Jun Ho Ji10, Kyong-Choun Chi11

1. Division of Hematology-Oncology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
2. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
3. Division of Hematology-Oncology, Department of Medicine, Myongji Hospital, Goyang-si, Gyeonggido, South Korea
4. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
5. Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, South Korea
6. Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
7. Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
8. Division of Hematology and Oncology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
9. Division of Hematology-Oncology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea
10. Division of Hematology-Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
11. Department of Surgery, Chung-Ang University College of Medicine, Seoul, South Korea

Abstract

Purpose: Two recent randomized, phase III trials in Asia (ACTS-GC and CLASSIC) documented the survival benefit of postoperative chemotherapy after D2 lymph node dissection in patients with gastric cancer. We sought to determine what factors influenced clinicians' choices of either S-1 or capecitabine plus oxaliplatin (CAPOX) as adjuvant therapy after curative D2 gastrectomy.

Materials and Methods: We retrospectively reviewed the clinicopathologic factors and adjuvant treatments for 435 patients from nine centers in Korea who were treated with either S-1 or CAPOX adjuvant chemotherapy after undergoing curative D2 gastrectomy between January 2013 and July 2014.

Results: Of the 435 patients, 204 (46.9%) were treated with S-1 and 231 (53.1%) were treated with CAPOX. The median age at diagnosis was 61 years (range, 30-88). CAPOX was prescribed more often for patients who were 65 years of age or younger than for patients who were age 65 or older (77.1% vs. 22.9%, P<0.0001). Of the patients in stage II, 121 (60.8%) were treated with S-1 and 78 (39.2%) were given CAPOX; however, of those in stage III, 83 (35.2%) received S-1 and 153 (64.8%) were treated with CAPOX (P<0.0001).

Conclusions: Clinicians only preferred CAPOX for younger patients with stage III gastric cancer after curative D2 gastrectomy. However, for elderly patients, clinicians more chose S-1 regardless of the stage.

Keywords: stomach neoplasms, chemotherapy, adjuvant, gastrectomy

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How to cite this article:
Lee HY, Hwang IG, Park SE, Kim MJ, Park SH, Kang JH, Kim YS, Oh SY, Won YW, Lee SI, Ji JH, Chi KC. Factors Influencing Clinicians' Choice of Adjuvant S-1 versus Capecitabine plus Oxaliplatin after Curative Gastrectomy in Patients with Gastric Cancer. J Cancer 2016; 7(12):1711-1715. doi:10.7150/jca.15598. Available from http://www.jcancer.org/v07p1711.htm