title: Changes in Standard Treatments and Postoperative Outcomes for Advanced Gastric Cancer at One Institute over an 11-Year Period.
abstract: BACKGROUND
  Reportedly, the recently established postoperative adjuvant chemotherapies (ADJs) with tegafur and uracil (UFT) or fluoropyrimidine S (S-1) show better survival than surgery alone in patients with advanced gastric cancer (GC). We analyzed chronological changes in postoperative prognosis of patients with advanced GC in our institute, and investigated the efficacy of ADJ in patients with stage II-III GC.
  
  
  METHODS
  Of 143 patients with stage II-III GC who underwent curative gastrectomy at Tottori University Hospital between 1998 and 2008, three died with operative complications within 1 month after surgery. The remaining 140 patients were followed to the end of 2013. We compared disease-free survival (DFS) and clinicopathological differences between 82 patients who underwent gastrectomy during 1998-2002 (Group A) and 58 patients who underwent gastrectomy during 2003-2008 (Group B).
  
  
  RESULTS
  Operative quality, as represented by number of dissected lymph nodes, was similar in both groups, but the recurrence rate of Group A (51.2%) was higher than in Group B (37.9%, P = 0.12) and the 5-year DFS rate of Group B (62.3%) was higher than that of Group A (50.2%, P = 0.095). In stage II, the 5-year DFS rate of patients in Group B (73.3%) was similar to Group A (77%), but at tumor stage III, the 5-year DFS rate of patients in Group B increased to 48.7%, compared with 33.1% of Group A. Between 2003 and 2008, S-1 was widely used as ADJ for stage II-III GC.
  
  
  CONCLUSIONS
  Postoperative ADJ with S-1 improved DFS of patients with stage III gastric cancer.
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Abdul
authors: A
authors: Kader
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Kozo
authors: K
authors: Miyatani
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Seigo
authors: S
authors: Takaya
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Tomoyuki
authors: T
authors: Matsunaga
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Yoji
authors: Y
authors: Fukumoto
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Tomohiro
authors: T
authors: Osaki
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Hiroaki
authors: H
authors: Saito
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Shinji
authors: S
authors: Otani
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Toshiro
authors: T
authors: Wakatsuki
authors: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors: Masahide
authors: M
authors: Ikeguchi
keywords: S-1; adjuvant chemotherapy; gastric cancer; tegafur and uracil