title: Loss of Lean Body Mass as an Independent Risk Factor for Continuation of S-1 Adjuvant Chemotherapy for Gastric Cancer.
abstract: OBJECTIVE
  Compliance with S-1 adjuvant chemotherapy is not satisfactory, and the aim of the present study was to clarify risk factors for the continuation of S-1 after gastrectomy.
  
  
  METHODS
  This retrospective study selected patients who underwent curative D2 surgery for gastric cancer, were diagnosed with stage II/III disease, had a creatinine clearance >60 ml/min, and received adjuvant S-1 at our institution between June 2010 and March 2014. The time to S-1 treatment failure (TTF) was calculated.
  
  
  RESULTS
  Fifty-eight patients were selected for the present study. When the TTF curves stratified by each clinical factor were compared using the log-rank test, lean body-mass loss (LBL) of 5 % was regarded as a critical cutoff point. Univariate Cox's proportional hazard analyses demonstrated that LBL was a significant independent risk factor for continuation. The 6-month continuation rate was 91.7 % in patients with an LBL < 5 %, and 66.3 % for patients with an LBL > 5 % (p = 0.031).
  
  
  CONCLUSIONS
  The present study demonstrated that LBL might be an important risk factor for a decrease in compliance to adjuvant chemotherapy with S-1 in patients with stage II/III gastric cancer who underwent D2 gastrectomy. A multicenter, double-blinded, prospective cohort study is necessary to confirm whether LBL would affect adjuvant S-1 continuation.
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.forename: Taiichi
authors.initials: T
authors.lastname: Kawabe
authors.forename: Hirohito
authors.initials: H
authors.lastname: Fujikawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hayashi
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yamada
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Tsuchida
authors.forename: Norio
authors.initials: N
authors.lastname: Yukawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Ogata
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Cho
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001823:Body Composition; D001835:Body Weight; D004338:Drug Combinations; D017097:Electric Impedance; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010094:Oxonic Acid / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005641:Tegafur / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid