The predictive factors of gastric cancer recurrence after the completion of adjuvant chemotherapy in advanced gastric cancer

• Yeon-Ji Kim ^[1] ; Woo Chul Chung ^[1] ; Gun Jung Youn ^[1] ; Kyong-Hwa Jun ^[1] ; Hyung-Min Chin ^[1]
  1. [1] Catholic University of Korea

     Catholic University of Korea

     Corea del Sur

     
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 111, Nº. 7, 2019, págs. 537-542
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen

  • Objective: the administration of adjuvant chemotherapy after a curative resection is accepted as the standard treatment to improve the prognosis of advanced gastric cancer. Nevertheless, the prognosis of recurrence-related gastric cancer is still not clinically satisfactory. We aimed to assess the therapeutic yield of a radical gastrectomy with D2 lymphadenectomy (R0 resection) and the completion of adjuvant chemotherapy. The predictive risk factors for recurrence were also assessed. Methods: a retrospective cohort study was designed with patients diagnosed with advanced gastric cancer. Patients with an R0 resection who had completed adjuvant chemotherapy were included in the study. Results: data from 130 patients who had undergone an R0 resection and had completed six cycles of adjuvant chemotherapy were analyzed. The chemotherapy compliance rate was 63.11% and the overall recurrence rate was 36.9%. The lymph node ratio (LNR), which was defined as the number of metastatic lymph nodes divided by the retrieved lymph nodes, was a significant risk factor in the lymph node-positive group (p < 0.01). This parameter had a relatively high sensitivity to predict recurrence compared with the 7th and 8th edition of the AJCC staging system, with an area under the curve of 0.735 (95% confidence interval: 0.639-0.832). Baseline CA19-9 level was a risk factor in the lymph node-negative group (p = 0.01). Conclusions: LNR and baseline CA19-9 levels, as simple markers, had strong predictive values for the recurrence of advanced gastric cancer. With regard to recurrence, more potent adjuvant therapy should be considered in high-risk patients.