Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer

Jeong Il Yu; Do Hoon Lim; Jeeyun Lee; Won Ki Kang; Se Hoon Park; Joon Oh Park; Young Suk Park; Ho Yeong Lim; Seung Tae Kim; Su Jin Lee; Sung Kim; Tae Sung Sohn; Jun Ho Lee; Ji Yeong An; Min Gew Choi; Jae Moon Bae; Hye Seung Kim; Soohyun Ahn

doi:10.1016/j.radonc.2018.07.002

Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer

Jeong Il Yu, Do Hoon Lim, Jeeyun Lee, Won Ki Kang, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Seung Tae Kim, Su Jin Lee, Sung Kim, Tae Sung Sohn, Jun Ho Lee, Ji Yeong An, Min Gew Choi, Jae Moon Bae, Hye Seung Kim, Soohyun Ahn

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Background and purpose: To investigate the role of adjuvant concurrent chemo-radiotherapy (CCRT) by analyzing the outcomes of adjuvant CCRT versus chemotherapy alone (CA) in patients with D2-resected gastric cancer with lymph node (LN) metastasis. Materials and methods: Patients with gastric cancer from the institutional registry who underwent curative D2 and R0 resection from December 2004 to January 2013 followed by adjuvant CCRT or CA and demonstrated pathologically confirmed LN metastasis without distant metastasis were included in the study. Results: A total of 1633 patients were included (909 patients in the adjuvant CCRT group and 724 patients in the CA group), and median follow-up was 65.4 months (range, 3.9–141.7 months). There was a significant difference in age (p < 0.0001), Lauren's classification (p = 0.02), number of LN metastases (p < 0.0001), and pN stage (p < 0.0001) between the CCRT and CA groups. During follow-up, recurrence was detected in 419 (25.7%) of patients overall, 236 (26.0%) in the CCRT group, and 183 (25.3%) in the CA group. Recurrence-free survival (RFS) was not significantly different between the CCRT and CA groups in univariable analysis (p = 0.92). After adjustment, pT/pN stage and perineural invasion showed statistical significance in multivariable Cox regression analysis; however, RFS was significantly higher in the CCRT group (p = 0.03, hazard ratio 0.801, 95% confidence interval 0.658–0.975). Conclusions: The adjusted RFS was significantly higher in the CCRT group than the CA group in patients with D2 resected LN metastatic gastric cancer.

Original language	English
Pages (from-to)	306-312
Number of pages	7
Journal	Radiotherapy and Oncology
Volume	129
Issue number	2
DOIs	https://doi.org/10.1016/j.radonc.2018.07.002
State	Published - Nov 2018

Bibliographical note

Funding Information:
This research was partly supported by a Basic Science Research Program through the National Research Foundation of Korea ( NRF ) funded by the Ministry of Education ( NRF-2017R1D1A1B03031275 ), and a grant from the Marine Biotechnology Program ( 20150220 ) funded by the Ministry of Oceans and Fisheries , Korea.

Funding Information:
This research was partly supported by a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03031275), and a grant from the Marine Biotechnology Program (20150220) funded by the Ministry of Oceans and Fisheries, Korea.

Publisher Copyright:
© 2018

Keywords

Adjuvant
Chemotherapy
Concurrent chemo-radiotherapy
Gastric cancer
Recurrence

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10.1016/j.radonc.2018.07.002

Cite this

Yu, J. I., Lim, D. H., Lee, J., Kang, W. K., Park, S. H., Park, J. O., Park, Y. S., Lim, H. Y., Kim, S. T., Lee, S. J., Kim, S., Sohn, T. S., Lee, J. H., An, J. Y., Choi, M. G., Bae, J. M., Kim, H. S., & Ahn, S. (2018). Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer. Radiotherapy and Oncology, 129(2), 306-312. https://doi.org/10.1016/j.radonc.2018.07.002

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title = "Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer",

abstract = "Background and purpose: To investigate the role of adjuvant concurrent chemo-radiotherapy (CCRT) by analyzing the outcomes of adjuvant CCRT versus chemotherapy alone (CA) in patients with D2-resected gastric cancer with lymph node (LN) metastasis. Materials and methods: Patients with gastric cancer from the institutional registry who underwent curative D2 and R0 resection from December 2004 to January 2013 followed by adjuvant CCRT or CA and demonstrated pathologically confirmed LN metastasis without distant metastasis were included in the study. Results: A total of 1633 patients were included (909 patients in the adjuvant CCRT group and 724 patients in the CA group), and median follow-up was 65.4 months (range, 3.9–141.7 months). There was a significant difference in age (p < 0.0001), Lauren's classification (p = 0.02), number of LN metastases (p < 0.0001), and pN stage (p < 0.0001) between the CCRT and CA groups. During follow-up, recurrence was detected in 419 (25.7%) of patients overall, 236 (26.0%) in the CCRT group, and 183 (25.3%) in the CA group. Recurrence-free survival (RFS) was not significantly different between the CCRT and CA groups in univariable analysis (p = 0.92). After adjustment, pT/pN stage and perineural invasion showed statistical significance in multivariable Cox regression analysis; however, RFS was significantly higher in the CCRT group (p = 0.03, hazard ratio 0.801, 95% confidence interval 0.658–0.975). Conclusions: The adjusted RFS was significantly higher in the CCRT group than the CA group in patients with D2 resected LN metastatic gastric cancer.",

keywords = "Adjuvant, Chemotherapy, Concurrent chemo-radiotherapy, Gastric cancer, Recurrence",

author = "Yu, {Jeong Il} and Lim, {Do Hoon} and Jeeyun Lee and Kang, {Won Ki} and Park, {Se Hoon} and Park, {Joon Oh} and Park, {Young Suk} and Lim, {Ho Yeong} and Kim, {Seung Tae} and Lee, {Su Jin} and Sung Kim and Sohn, {Tae Sung} and Lee, {Jun Ho} and An, {Ji Yeong} and Choi, {Min Gew} and Bae, {Jae Moon} and Kim, {Hye Seung} and Soohyun Ahn",

note = "Funding Information: This research was partly supported by a Basic Science Research Program through the National Research Foundation of Korea ( NRF ) funded by the Ministry of Education ( NRF-2017R1D1A1B03031275 ), and a grant from the Marine Biotechnology Program ( 20150220 ) funded by the Ministry of Oceans and Fisheries , Korea. Funding Information: This research was partly supported by a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03031275), and a grant from the Marine Biotechnology Program (20150220) funded by the Ministry of Oceans and Fisheries, Korea. Publisher Copyright: {\textcopyright} 2018",

year = "2018",

month = nov,

doi = "10.1016/j.radonc.2018.07.002",

language = "English",

volume = "129",

pages = "306--312",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

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TY - JOUR

T1 - Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer

AU - Yu, Jeong Il

AU - Lim, Do Hoon

AU - Lee, Jeeyun

AU - Kang, Won Ki

AU - Park, Se Hoon

AU - Park, Joon Oh

AU - Park, Young Suk

AU - Lim, Ho Yeong

AU - Kim, Seung Tae

AU - Lee, Su Jin

AU - Kim, Sung

AU - Sohn, Tae Sung

AU - Lee, Jun Ho

AU - An, Ji Yeong

AU - Choi, Min Gew

AU - Bae, Jae Moon

AU - Kim, Hye Seung

AU - Ahn, Soohyun

N1 - Funding Information: This research was partly supported by a Basic Science Research Program through the National Research Foundation of Korea ( NRF ) funded by the Ministry of Education ( NRF-2017R1D1A1B03031275 ), and a grant from the Marine Biotechnology Program ( 20150220 ) funded by the Ministry of Oceans and Fisheries , Korea. Funding Information: This research was partly supported by a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03031275), and a grant from the Marine Biotechnology Program (20150220) funded by the Ministry of Oceans and Fisheries, Korea. Publisher Copyright: © 2018

PY - 2018/11

Y1 - 2018/11

N2 - Background and purpose: To investigate the role of adjuvant concurrent chemo-radiotherapy (CCRT) by analyzing the outcomes of adjuvant CCRT versus chemotherapy alone (CA) in patients with D2-resected gastric cancer with lymph node (LN) metastasis. Materials and methods: Patients with gastric cancer from the institutional registry who underwent curative D2 and R0 resection from December 2004 to January 2013 followed by adjuvant CCRT or CA and demonstrated pathologically confirmed LN metastasis without distant metastasis were included in the study. Results: A total of 1633 patients were included (909 patients in the adjuvant CCRT group and 724 patients in the CA group), and median follow-up was 65.4 months (range, 3.9–141.7 months). There was a significant difference in age (p < 0.0001), Lauren's classification (p = 0.02), number of LN metastases (p < 0.0001), and pN stage (p < 0.0001) between the CCRT and CA groups. During follow-up, recurrence was detected in 419 (25.7%) of patients overall, 236 (26.0%) in the CCRT group, and 183 (25.3%) in the CA group. Recurrence-free survival (RFS) was not significantly different between the CCRT and CA groups in univariable analysis (p = 0.92). After adjustment, pT/pN stage and perineural invasion showed statistical significance in multivariable Cox regression analysis; however, RFS was significantly higher in the CCRT group (p = 0.03, hazard ratio 0.801, 95% confidence interval 0.658–0.975). Conclusions: The adjusted RFS was significantly higher in the CCRT group than the CA group in patients with D2 resected LN metastatic gastric cancer.

AB - Background and purpose: To investigate the role of adjuvant concurrent chemo-radiotherapy (CCRT) by analyzing the outcomes of adjuvant CCRT versus chemotherapy alone (CA) in patients with D2-resected gastric cancer with lymph node (LN) metastasis. Materials and methods: Patients with gastric cancer from the institutional registry who underwent curative D2 and R0 resection from December 2004 to January 2013 followed by adjuvant CCRT or CA and demonstrated pathologically confirmed LN metastasis without distant metastasis were included in the study. Results: A total of 1633 patients were included (909 patients in the adjuvant CCRT group and 724 patients in the CA group), and median follow-up was 65.4 months (range, 3.9–141.7 months). There was a significant difference in age (p < 0.0001), Lauren's classification (p = 0.02), number of LN metastases (p < 0.0001), and pN stage (p < 0.0001) between the CCRT and CA groups. During follow-up, recurrence was detected in 419 (25.7%) of patients overall, 236 (26.0%) in the CCRT group, and 183 (25.3%) in the CA group. Recurrence-free survival (RFS) was not significantly different between the CCRT and CA groups in univariable analysis (p = 0.92). After adjustment, pT/pN stage and perineural invasion showed statistical significance in multivariable Cox regression analysis; however, RFS was significantly higher in the CCRT group (p = 0.03, hazard ratio 0.801, 95% confidence interval 0.658–0.975). Conclusions: The adjusted RFS was significantly higher in the CCRT group than the CA group in patients with D2 resected LN metastatic gastric cancer.

KW - Adjuvant

KW - Chemotherapy

KW - Concurrent chemo-radiotherapy

KW - Gastric cancer

KW - Recurrence

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AN - SCOPUS:85050104596

SN - 0167-8140

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IS - 2

ER -

Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer

Abstract

Bibliographical note

Keywords

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