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5-fluorouracil, mitomycin-C, and polysaccharide-K adjuvant chemoimmunotherapy for locally advanced gastric cancer: the prognostic significance of frequent perineural invasion

Choi, JH; Kim, YB; Lim, HY; Park, JS; Kim, HC; Cho, YK; Han, SW; Kim, MW; Joo, HJ
Hepato-gastroenterology, 54(73):290-297, 2007
Journal Title
BACKGROUND/AIMS: Although adjuvant chemotherapy has demonstrated small but significant survival benefit in locally advanced gastric cancer in several meta-analyses, optimal chemotherapy regimen remains to be determined.

METHODOLOGY: We retrospectively analyzed the survival of 207 gastric cancer patients (stage IB: 19, II: 65, IIIA: 58, IIIB: 28, IV: 37) who underwent 5-fluorouracil (5-FU), mitomycin-C (MMC), and polysaccharide-K (PSK) chemoimmunotherapy (CITX) after curative resection (FM group). The survival of FM group was compared with that of historical control cohort of 103 patients with almost identical stage distribution who received 5-FU and doxorubicin-based chemotherapy (FA group).

RESULTS: Five-year disease-free survival and overall survival (OS) of FM group were 58.7% and 59.1%, respectively. Frequent perineural invasion was significantly associated with poor OS (p = 0.01) in multivariate analysis. There was no statistically significant difference in 5-year OS (59.1% vs. 56.2%, p = 0.637) between FM and FA groups. FM group showed superior 5-year OS (84.4% vs. 67.6%, p = 0.019) compared with FA group in stage IB or II patients without significant difference (p = 0.222) in stage IIIA to IV.

CONCLUSIONS: 5-FU, MMC, and PSK CITX is as effective as 5-FU and doxorubicin-based chemotherapy. Moreover, frequent perineural invasion seems to be an important poor prognostic factor.
MeSH terms
Adenocarcinoma/drug therapy*Adenocarcinoma/mortalityAdenocarcinoma/pathologyAdenocarcinoma/surgeryAdultAntibiotics, Antineoplastic/administration & dosage*Antineoplastic Combined Chemotherapy Protocols/therapeutic use*Chemotherapy, AdjuvantFemaleFluorouracil/administration & dosage*HumansImmunotherapyMaleMiddle AgedMitomycin/administration & dosage*Multivariate AnalysisNeoplasm InvasivenessPeripheral Nerves/pathology*PrognosisStomach Neoplasms/drug therapy*Stomach Neoplasms/mortalityStomach Neoplasms/pathologyStomach Neoplasms/surgeryv
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Hematology-Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
최, 진혁김, 영배박, 준성김, 효철조, 용관한, 상욱김, 명욱주, 희재
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