ORIGINAL RESEARCH ARTICLE
Prognostic Factors Associated with Locally Advanced Gastric Cancer in Patients Treated with Adjuvant Chemotherapy
Received Date : 29 Jun 2022
Accepted Date : 24 Oct 2022
Available Online : 07 Nov 2022
Hasan Çağrı YILDIRIMa, Deniz Can GÜVENa, Elvin CHALABIYEVa, Hakan TABANa,
Feride YILMAZa, Serkan YAŞARa, Fatih KUŞa, Arif AKYILDIZa, Süleyman Çağın GÜRBÜZb, Hüseyin SAYINb, Gözde KAVGACIa, Şuayib YALÇINa, Ömer DİZDARa
aDepartment of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Türkiye
bDepartment of Internal Medicine, Hacettepe University Medical School, Ankara, Türkiye
Doi: 10.37047/jos.2022-92230 - Article's Language: EN
J Oncol Sci. 2022;8(3):143-7
ABSTRACT
Objective: Surgery followed by chemotherapy with or without radiotherapy and perioperative chemotherapy represents the
standard treatment modality in locally advanced gastric cancer patients. Adjuvant radiotherapy has been shown to have no benefits in these
patients, especially those undergoing D2 dissection without neoadjuvant treatment. The goal of our study was to identify the prognostic factors
associated with adjuvant treatments, particularly radiotherapy. Material and Methods: We evaluated the clinical, laboratory, and histological
features and survival in locally advanced gastric cancer patients who underwent upfront gastric resection without neoadjuvant therapy
and were subsequently treated with adjuvant chemotherapy comprising capecitabine-oxaliplatin. Parameters with significant p-values in univariate
analysis were included in multivariate Cox regression analysis. Results: A total of 56 patients were included, and the median followup
period was 33.2 months. The mean age was 61.23±8.89 years. The median disease-free survival (DFS) was 37.80 months (95% confidence
interval: 22.30-53.30). The 5-year DFS and overall survival (OS) rates were 43.4% and 60.8%, respectively. In univariate analysis, lymph node
involvement, diffuse histology, presence of lymphovascular invasion, positive surgical margin, presence of perineural invasion, absence of
radiotherapy, and high lactate dehydrogenase (LDH) levels were found to be associated with shorter DFS and OS. In multivariate Cox regression
analysis, diffuse histology, absence of radiotherapy, and high LDH levels were found to be associated with shorter DFS and OS. Conclusion:
The long-term survival rates in our study were encouraging. Inflammatory markers, tumor histology, and radiotherapy might have
prognostic value in identifying high-risk patients who could benefit from intensive therapy.
Keywords: Gastric cancer; adjuvant chemotherapy; prognostic factor
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