Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study
Abstract Aim Postoperative adjuvant chemotherapy is known to enhance cure rates and is thus recommended for stages pII to pIII. However, specific guidelines for such treatment in elderly gastric cancer (GC) patients are currently lacking. This study examines the impact of adjuvant chemotherapy on th...
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Springer
2025-05-01
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| Series: | Journal of Cancer Research and Clinical Oncology |
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| Online Access: | https://doi.org/10.1007/s00432-025-06230-w |
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| author | Zheng-Zheng Shen En-Ze Li Ruo-Lan Zhang Meng-Xuan Cao Yan-Qiang Zhang Qing Yang Can Hu Si-Wei Pan Zhi-Yuan Xu Zai-Sheng Ye Jing-Yang He |
| author_facet | Zheng-Zheng Shen En-Ze Li Ruo-Lan Zhang Meng-Xuan Cao Yan-Qiang Zhang Qing Yang Can Hu Si-Wei Pan Zhi-Yuan Xu Zai-Sheng Ye Jing-Yang He |
| author_sort | Zheng-Zheng Shen |
| collection | DOAJ |
| description | Abstract Aim Postoperative adjuvant chemotherapy is known to enhance cure rates and is thus recommended for stages pII to pIII. However, specific guidelines for such treatment in elderly gastric cancer (GC) patients are currently lacking. This study examines the impact of adjuvant chemotherapy on the postoperative survival of these patients. Methods We reviewed a total of 7749 patients with GC who underwent radical gastrectomy at Zhejiang Cancer Hospital and Fujian Cancer Hospital from January 2007 to December 2019. We conducted univariate and multivariate Cox regression analyses to investigate the impact of clinicopathological factors on overall survival (OS) and cancer-specific survival (CSS) in these patients. Additionally, we created a meta-analysis forest plot and employed propensity score matching (PSM) to mitigate confounding bias. Results Age and adjuvant chemotherapy were independent risk factors for OS and CSS. Stratified analysis based on chemotherapy use revealed a statistically significant difference in OS and CSS between younger patients who did and did not receive adjuvant chemotherapy. In contrast, no significant differences in OS and CSS were observed between older patients with or without adjuvant chemotherapy. These findings remained consistent after propensity score matching (PSM). Conclusions Age and adjuvant chemotherapy are independent risk factors for OS and CSS in patients with stage II/III GC; for patients with stage II/III gastric cancer aged ≥ 75 years, shared decision-making should be made taking into account functional status and comorbidities, rather than conventional adjuvant chemotherapy. |
| format | Article |
| id | doaj-art-b6ecdb8a92834cb1b15bd2af012562f9 |
| institution | DOAJ |
| issn | 1432-1335 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Cancer Research and Clinical Oncology |
| spelling | doaj-art-b6ecdb8a92834cb1b15bd2af012562f92025-08-20T02:39:23ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-05-01151511410.1007/s00432-025-06230-wAdjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective studyZheng-Zheng Shen0En-Ze Li1Ruo-Lan Zhang2Meng-Xuan Cao3Yan-Qiang Zhang4Qing Yang5Can Hu6Si-Wei Pan7Zhi-Yuan Xu8Zai-Sheng Ye9Jing-Yang He10Department of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Gastric Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital (Fujian Branch of Fudan University Shanghai Cancer Center)Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesAbstract Aim Postoperative adjuvant chemotherapy is known to enhance cure rates and is thus recommended for stages pII to pIII. However, specific guidelines for such treatment in elderly gastric cancer (GC) patients are currently lacking. This study examines the impact of adjuvant chemotherapy on the postoperative survival of these patients. Methods We reviewed a total of 7749 patients with GC who underwent radical gastrectomy at Zhejiang Cancer Hospital and Fujian Cancer Hospital from January 2007 to December 2019. We conducted univariate and multivariate Cox regression analyses to investigate the impact of clinicopathological factors on overall survival (OS) and cancer-specific survival (CSS) in these patients. Additionally, we created a meta-analysis forest plot and employed propensity score matching (PSM) to mitigate confounding bias. Results Age and adjuvant chemotherapy were independent risk factors for OS and CSS. Stratified analysis based on chemotherapy use revealed a statistically significant difference in OS and CSS between younger patients who did and did not receive adjuvant chemotherapy. In contrast, no significant differences in OS and CSS were observed between older patients with or without adjuvant chemotherapy. These findings remained consistent after propensity score matching (PSM). Conclusions Age and adjuvant chemotherapy are independent risk factors for OS and CSS in patients with stage II/III GC; for patients with stage II/III gastric cancer aged ≥ 75 years, shared decision-making should be made taking into account functional status and comorbidities, rather than conventional adjuvant chemotherapy.https://doi.org/10.1007/s00432-025-06230-wGastric cancerAdjuvant chemotherapyElderly patients |
| spellingShingle | Zheng-Zheng Shen En-Ze Li Ruo-Lan Zhang Meng-Xuan Cao Yan-Qiang Zhang Qing Yang Can Hu Si-Wei Pan Zhi-Yuan Xu Zai-Sheng Ye Jing-Yang He Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study Journal of Cancer Research and Clinical Oncology Gastric cancer Adjuvant chemotherapy Elderly patients |
| title | Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study |
| title_full | Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study |
| title_fullStr | Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study |
| title_full_unstemmed | Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study |
| title_short | Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study |
| title_sort | adjuvant chemotherapy may have no significant survival benefit in older patients with stage ii iii gastric cancer a multicenter retrospective study |
| topic | Gastric cancer Adjuvant chemotherapy Elderly patients |
| url | https://doi.org/10.1007/s00432-025-06230-w |
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