Adjuvant S-1 Improves Five-Year Outcomes in Gastric Cancer

Oral fluoropyrimidine derivative, S-1, improves overall, relapse-free survival at five years

WEDNESDAY, Oct. 19 (HealthDay News) -- Postoperative adjuvant therapy with oral fluoropyrimidine derivative, S-1, improves overall and relapse-free survival at five years in patients with stage II or III gastric cancer who undergo D2 gastrectomy, according to a study published online Oct. 17 in the Journal of Clinical Oncology.

Mitsuru Sasako, M.D., Ph.D., from the Hyogo College of Medicine in Japan, and colleagues investigated the five-year follow-up data from patients enrolled in the Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer. Patients with histologically confirmed stage II or III gastric cancer who underwent gastrectomy D2 lymphadenectomy were randomized to surgery only or to receive S-1 after surgery. A six week cycle comprising four weeks of S-1 (80 to 120 mg per day), followed by two weeks of rest was repeated for one year. Overall survival, and relapse-free survival and safety were the primary and secondary end points, respectively.

The investigators found that, at five years, the overall survival was 71.7 and 61.1 percent in the S-1 and surgery-only groups, respectively (hazard ratio [HR], 0.669). The five-year relapse-free survival rate was 65.4 and 53.1 percent in the S-1 and surgery groups, respectively (HR, 0.653). No correlation was found between treatment and gender, age, disease stage, or histologic type.

"This five-year follow-up study confirmed that adjuvant chemotherapy with S-1 given for 1 year after surgery improved overall survival and relapse-free survival at 5 years in patients with stage II or III gastric cancer who underwent D2 gastrectomy," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies, including Taiho Pharmaceutical, which funded the study and developed S-1.

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