title: Evaluation of docetaxel- and oxaliplatin-based adjuvant chemotherapy in postgastrectomy gastric cancer patients reveals obvious survival benefits in docetaxel-treated mixed signet ring cell carcinoma patients.
abstract: The purpose of this study was to determine the disease-free and overall survival (DFS and OS, respectively) in 991 postgastrectomy gastric cancer patients untreated (n = 372) or treated with either oxaliplatin-based (n = 376) or docetaxel-based (n = 243) chemotherapy and to identify prognostic factors that could help establish subgroups of patients who would benefit from such treatment. The median follow-up duration was 55.3 months (range 31.2-90.8 months). Subgroup analyses revealed that gastric adenocarcinoma (DFS 56.9 vs 53.2 months, P = 0.180, χ(2) = 1.802; OS not reached vs 70.7 months, P = 0.521, χ(2) = 0.412), but not absolute signet ring cell (SRC) carcinoma (DFS 15.1/18.0 vs 10.1 months, P = 0.171/0.259, χ(2) = 1.874/1.275; OS 21.0/26.1 vs 20.5 months, P = 0.551/0.196, χ(2) = 0.355/1.674), patients undergoing either docetaxel- or oxaliplatin-based chemotherapy had a lower risk of recurrence and increased survival in comparison to those without chemotherapy. In the mixed SRC carcinoma patients, DFS and OS of patients treated with docetaxel-based regimen had a longer survival (DFS 50.1 vs 29.9 months, P = 0.046, χ(2) = 3.987; OS not reached vs 48.6 months, P = 0.016, χ(2) = 5.854) and lower risk of recurrence and death (DFS HR 0.540, 95 % CI 0.355-0.874, P = 0.012; OS HR 0.452, 95 % CI 0.259-0.790, P = 0.005) than oxaliplatin-based chemotherapy. Cumulatively, our results indicate that adjuvant chemotherapy is beneficial and that docetaxel-based regimen should be considered for patients with mixed SRC carcinoma.
authors.affiliation: Department of Comprehensive Treatment Oncology, Chinese People's Liberation Army General Hospital, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Shi
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.forename: Qian
authors.initials: Q
authors.lastname: Wu
authors.forename: Yalin
authors.initials: Y
authors.lastname: Han
authors.forename: Rui
authors.initials: R
authors.lastname: Qin
authors.forename: Baoqing
authors.initials: B
authors.lastname: Jia
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
authors.forename: Lixin
authors.initials: L
authors.lastname: Wei
authors.forename: Guanghai
authors.initials: G
authors.lastname: Dai
authors.forename: Shunchang
authors.initials: S
authors.lastname: Jiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018279:Carcinoma, Signet Ring Cell / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D000077143:Docetaxel; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D000077150:Oxaliplatin; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D000077143:Docetaxel