S-1 + Oxaliplatin as an Adjuvant Chemotherapy for Patients with Curative Resection of Double Cancer of Stomach and Rectum

Purpose: To evaluate the survival benefit of adjuvant chemotherapy after curative resection in serosa-negative gastric cancer patients (excluding patients who were T1N0), we conducted a multicenter phase III clinical trial in which 13 cancer centers in Japan participated. Patients and Methods: From January 1993 to December 1994, 252 patients were enrolled into the study and allocated randomly to adjuvant chemotherapy or surgery alone. The chemotherapy comprised intravenous mitomycin 1.33 mg/m2, fluorouracil (FU) 166.7 mg/m2, and cytarabine 13.3 mg/m2 twice weekly for the first 3 weeks after surgery, and oral FU 134 mg/m2 daily for the next 18 months for a total dose of 67 g/m2. The primary end point was relapse-free survival. Overall survival and the site of recurrence were secondary end points. Results: Ninety-eight percent of patients underwent gastrectomy with D2 or greater lymph node dissection. There were no treatment-related deaths and few serious adverse events. There was no significant difference in relapse-free and overall survival between the arms (5-year relapse-free survival 88.8% chemotherapy v 83.7% surgery alone; P = .14 and 5-year survival 91.2% chemotherapy v 86.1% surgery alone; P = .13, respectively). Nine patients (7.1%) in the chemotherapy arm and 17 patients (13.8%) in the surgery-alone arm had cancer recurrence. Conclusion: There was no statistically significant relapse-free or overall survival benefit with this adjuvant chemotherapy for patients with macroscopically serosa-negative gastric cancer after curative resection, and there was no statistical difference between the two arms relating to the types of cancer recurrence. We do not recommend adjuvant chemotherapy with this regimen for this population in clinical practice.

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Prospective Randomized Controlled Trial Comparing Adjuvant Chemotherapy vs. No Chemotherapy for Patients with Carcinoma of Gallbladder Undergoing Curative Resection

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-021-05143-6 ◽

2021 ◽

Author(s):

Sundeep Singh Saluja ◽

Phani Kumar Nekarakanti ◽

Pramod Kumar Mishra ◽

Anurita Srivastava ◽

Kishore Singh

Keyword(s):

Randomized Controlled Trial ◽

Adjuvant Chemotherapy ◽

Curative Resection ◽

Controlled Trial ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

Carcinoma Of Gallbladder

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Adjuvant chemotherapy enhances long-term survival of patients with advanced gastric cancer following curative resection

Journal of Surgical Oncology ◽

10.1002/jso.2930450307 ◽

1990 ◽

Vol 45 (3) ◽

pp. 169-172 ◽

Cited By ~ 31

Author(s):

Yoshihiko Maehara ◽

Sunao Moriguchi ◽

Yoshihisa Sakaguchi ◽

Yasunori Emi ◽

Shunji Kohnoe ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Advanced Gastric Cancer ◽

Curative Resection ◽

Term Survival ◽

Long Term Survival

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Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy in Stage III Colon Cancer

Annals of Surgical Oncology ◽

10.1245/s10434-016-5613-5 ◽

2016 ◽

Vol 24 (1) ◽

pp. 227-235 ◽

Cited By ~ 12

Author(s):

Chang Gon Kim ◽

Joong Bae Ahn ◽

Minkyu Jung ◽

Seung Hoon Beom ◽

Su Jin Heo ◽

...

Keyword(s):

Colon Cancer ◽

Adjuvant Chemotherapy ◽

Prognostic Factor ◽

Carcinoembryonic Antigen ◽

Curative Resection ◽

Stage Iii ◽

Antigen Level ◽

Stage Iii Colon Cancer ◽

Preoperative Serum ◽

Serum Carcinoembryonic Antigen

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Quality of life after curative resection for rectal cancer in patients treated with adjuvant chemotherapy compared with observation: results of the randomized phase III SCRIPT trial

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.10.114 ◽

2019 ◽

Vol 45 (2) ◽

pp. e4

Author(s):

M. van der Valk ◽

D. Hilling ◽

E. Meershoek-Klein Kranenbarg ◽

K. Peeters ◽

E. Kapiteijn ◽

...

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Adjuvant Chemotherapy ◽

Curative Resection ◽

Phase Iii ◽

Observation Results

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Efficacy of aspirin for stage III colorectal cancer: a randomized double-blind placebo-controlled trial (JCOG1503C, EPISODE-III trial)

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyz106 ◽

2019 ◽

Vol 49 (10) ◽

pp. 985-990 ◽

Cited By ~ 1

Author(s):

Kenichi Miyamoto ◽

Atsuo Takashima ◽

Junki Mizusawa ◽

Yuya Sato ◽

Yasuhiro Shimada ◽

...

Keyword(s):

Colorectal Cancer ◽

Adjuvant Chemotherapy ◽

Adverse Events ◽

Curative Resection ◽

Disease Free Survival ◽

Phase Iii ◽

Stage Iii ◽

Double Blind ◽

Free Survival ◽

Double Blind Placebo

Abstract Adjuvant chemotherapy is the current standard treatment for stage III colorectal cancer after curative resection. However, the prognosis of stage III colorectal cancer is still poor even after curative resection and adjuvant chemotherapy. Several observational studies suggested that the anti-tumor effect of aspirin. Therefore, we planned a randomized double-blind placebo-controlled phase III trial, which commenced in Japan in March 2018, to confirm the superiority of aspirin over placebo added to adjuvant chemotherapy in terms of disease-free survival (DFS) for stage III colorectal cancer patients after curative resection. A total of 880 patients will be accrued from 20 Japanese institutions within 3 years. The primary endpoint is DFS and the secondary endpoints are overall survival, relapse-free survival, relative dose intensity, adverse events, and serious adverse events. This trial has been registered at Japan Registry of Clinical Trials as jRCTs031180009 (https://jrct.niph.go.jp/detail/589).

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Time to adjuvant chemotherapy (TTAC) after open or laparoscopic resection surgeries in colorectal cancers (CRC).

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.768 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 768-768

Author(s):

Selene A. Miller ◽

Laura Sevick ◽

Sergio Acuna ◽

Marck Mercado ◽

Nancy N. Baxter ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Curative Resection ◽

Laparoscopic Resection ◽

Meta Analysis ◽

Disease Free Survival ◽

Open Resection ◽

Gastrointestinal Complications ◽

Increased Risk ◽

Time To Initiation ◽

Procedural Complication

768 Background: This single institution retrospective study evaluates the reason for delay in Time To Adjuvant Chemotherapy (TTAC) from curative resection surgery to start of adjuvant therapy in CRC. The reason for this study was to determine if type of surgery (laparoscopic versus open) increased TTAC of which evidence indicates poorer disease free survival and overall survival (Biagi J, Raphael M, Mackillop W, Kong W, King W, Booth C. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: a systematic review and meta-analysis. JAMA, 305(22):2335-42. doi: 10.1001/jama.2011.749.) Methods: CRC patients treated at St. Michael’s Hospital in Toronto, Canada were included if diagnosed with stage II or III disease, underwent curative resection surgery between January 1, 2006, and December 31, 2012, and either received systemic adjuvant chemotherapy or surveillance protocol. Results: Among 259 patients, 92 patients (35.7%) underwent curative laparoscopic resection and 166 open resection (64.3%). Intraoperative and/or postoperative complications were experienced in 73 patients. Complications were less prevalent among patients who underwent laparoscopic surgery versus open resection (11.9% vs. 36.8%; p<0.0001). Of these 73 complications, wound infection (39.7%), intraoperative procedural complication (14.3%), and postoperative gastrointestinal complications (6.4%) were most prevalent. After adjusting for complication and clustering within the operating surgeon, there were no statistical differences in TTAC between open (51.310 ± 1.7 days) and laparoscopic (49.2 ± 1.6 days) resection surgeries (p=0.1996). However, presence of a complication was associated with delay in TTAC (HR 0.501; 95% CI, 0.43-0.58; p<0.001). Conclusions: TTAC in CRC patients does not differ statically for each type of resection surgery. However, presence of a complication is associated with delays in TTAC and is over three-fold more prevalent in open than laparoscopic resections. Therefore, there is an increased risk of delay in TTAC for open resection surgeries than laparoscopic resections due to a higher prevalence of surgical complications.

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