alexa Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer.
Gastroenterology

Gastroenterology

Journal of Gastrointestinal & Digestive System

Author(s): Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H,

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Abstract PURPOSE: The first planned interim analysis (median follow-up, 3 years) of the Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer confirmed that the oral fluoropyrimidine derivative S-1 significantly improved overall survival, the primary end point. The results were therefore opened at the recommendation of an independent data and safety monitoring committee. We report 5-year follow-up data on patients enrolled onto the ACTS-GC study. PATIENTS AND METHODS: Patients with histologically confirmed stage II or III gastric cancer who underwent gastrectomy with D2 lymphadenectomy were randomly assigned to receive S-1 after surgery or surgery only. S-1 (80 to 120 mg per day) was given for 4 weeks, followed by 2 weeks of rest. This 6-week cycle was repeated for 1 year. The primary end point was overall survival, and the secondary end points were relapse-free survival and safety. RESULTS: The overall survival rate at 5 years was 71.7\% in the S-1 group and 61.1\% in the surgery-only group (hazard ratio [HR], 0.669; 95\% CI, 0.540 to 0.828). The relapse-free survival rate at 5 years was 65.4\% in the S-1 group and 53.1\% in the surgery-only group (HR, 0.653; 95\% CI, 0.537 to 0.793). Subgroup analyses according to principal demographic factors such as sex, age, disease stage, and histologic type showed no interaction between treatment and any characteristic. CONCLUSION: On the basis of 5-year follow-up data, postoperative adjuvant therapy with S-1 was confirmed to improve overall survival and relapse-free survival in patients with stage II or III gastric cancer who had undergone D2 gastrectomy. This article was published in J Clin Oncol and referenced in Journal of Gastrointestinal & Digestive System

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