title: Risk factors for 6-month continuation of S-1 adjuvant chemotherapy for resected pancreatic cancer.
abstract: BACKGROUND
  The factors which affect the 6-month continuation of adjuvant chemotherapy with S-1 have not been fully evaluated in pancreatic cancer. The objective of this retrospective study was to clarify the risk factors for the discontinuation of S-1 adjuvant chemotherapy after 6 months of treatment.
  
  
  METHODS
  The study included patients who underwent curative surgery for pancreatic cancer, were diagnosed with stage II or III disease, had a serum creatinine level ≤1.2 mg/dl and received adjuvant S-1 between June 2007 and March 2014.
  
  
  RESULTS
  Forty patients were eligible for the present study. A comparison of the 6-month continuation stratified by each clinical factor using the log-rank test revealed a significant difference in the creatinine clearance (CCr) between the patients who continued and discontinued the treatment. A CCr of 60 ml/min was regarded as a critical point. The uni- and multivariate Cox's proportional hazard analyses demonstrated that the CCr was the only significant independent predictive factor. The 6-month continuation rate was 70.8 % in the patients with a CCr ≥60 ml/min and was 25.0 % in patients with a CCr <60 ml/min (P = 0.008). The patients with a CCr <60 ml/min developed adverse events more frequently and earlier than those with a CCr ≥60 ml/min.
  
  
  CONCLUSIONS
  A CCr < 60 ml/min was a significant risk factor for the 6-month discontinuation of S-1 adjuvant chemotherapy in pancreatic cancer patients, even though the renal function was judged to be normal based on the serum creatinine level. Careful attention is therefore required to improve the S-1 continuation in patients with a CCr < 60 ml/min.
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan, aoyamat@kcch.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Katayama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Murakawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asari
authors.forename: Amane
authors.initials: A
authors.lastname: Kanazawa
authors.forename: Akio
authors.initials: A
authors.lastname: Higuchi
authors.forename: Manabu
authors.initials: M
authors.lastname: Shiozawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Ueno
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Shinnichi
authors.initials: S
authors.lastname: Ohkawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Akaike
authors.forename: Naoto
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.forename: Soichiro
authors.initials: S
authors.lastname: Morinaga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003404:Creatinine / Q000097:blood / Q000652:urine; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D003404:Creatinine