What make differences in the outcome of adjuvant treatments for resected gastric cancer?

Table 1 Recent epoch making adjuvant trials showing survival benefit

Reporter/group	Regimen	Patients	3 ysr/treated	3 ysr/control
Macdonald/2001 (SWOG INT0116)	FL + (Rad. + FL)	Curat. D2	50	41
Cunningham/2006 (MAGIC)	EPF (peri-op.)	Curat.	361	231
Sakuramoto/2007 (ACTS-GC)	S-1	II-III	80.1	70.1
Ychou/2011 (FNCLCC/FFCD)	CDDP + 5-FU (peri-op.)	Curat.res.	381	241
Bang/2012 (CLASSIC)	Cape. + Oxal.	II-IIIB	74	51

¹Five year survival rate. 3 ysr: 3 year survival rate (%); FL: 5fluorouracil + leucovorin, Rad.: Radiation; Curat.: Curative; EPF: Epirubicin + CDDP + 5-FU; Cape.: Capecitabine; Oxal.: Oxaliplatin; peri-op: Peri-operative.

Table 2 Postoperative adjuvant chemotherapy

Reporter/year	Regimens vs Surgery alone	Patients	OS 5ysr (%)
			Treated	Control
Nakajima/1984	MFC + F/MF’C + F’	Curat. Res.	68.4/62.5	51.4
Coombes/1990	FAM	Curat. Res.	45.7	35.4
Krook/1991	FA	Curat. Res.	32	33
Macdonald/1995	FAM	I-III	37	32
Lise/1995	FAM2	II, III	42 mo1	36 mo1
Grau/1998	MMC + FT	Curat. Res.	672	45
Nakajima/1999 (JACOG8801)	MF + UFT	S(+)	85.8	82.9
Neri/2001	ELF	N(+)	30.22	12.6
Bajetta/2002	ELF	N(+)	52	48
Nashimoto/2003 (JCOG9206-1)	MFC + F	Curat. Res. S(-)	91.2	86.1
Chipponi/2004	FLP	S(+) or N(+)	39	39
Bouche/2005 (FFCD)	FP	II-IV	46.6	41.9
De Vita/2007 (GOIM 9602)	ELFE	IB-IIIB	48	43.5
Nakajima/2007 (NSAS-GC)	UFT	T2/N1−2	862	73
Di Costanza/ 2008 (GOIRC)	PELF	IB-IV	47.6	48.7
Sasako/2011 (ACTS-GC)	S-1	II-III	71.72	61.1
Miyashiro/2011	CDDPip + CFiv	S(+), curative	62	60.9
Noh/2013 (CLASSIC)	Cape. + Oxal.	II-IIIB	782	69
Kang/2013 (AMC0201)	MMC + 5’FUDR (MF’) vs MF’ + CDDP	II-IV	61.1	57.9
Lee/2012 (ARTIST)	Cape. + CDDP(XP) vs XP + Rad. + XP	Curative, D2	78.23	74.2

¹Median survival time (month);

²Statistically significant;

³Three year Disease free survival. OS 5ysr: Overall 5 year survival rate; MFC/F: Mitomycin C (MMC) + 5-FU + Cytosine arabinoside(CA) iv, and oral 5-FU; MF’C/F’: MMC + Ftoraful (FT) + CA iv and oral ftoraful; FAM: 5-FU + Adriamycin + MMC; FA: 5-FU + Adriamycin; FAM2: Modified 5-FU + Doxorubicin + MMC; MF+UFT: MMC + 5-FU iv and oral UFT; ELF: Etoposide + Leucovorin + 5-FU; FLP: 5-FU + Leucovorin + CDDP; FP: 5-FU + CDDP; ELFE: Epirubicin + Leucovorin + 5-FY + Etoposide; PELF: 5-FU + Leucovorin + CDDP + Epidoxorubicin; CDDPip + CFiv: CDDP ip + CDDP + 5-FU iv; S(+): Serosa involved; Curat. Res.: Curative resection.

Table 3 Phase III Neoadjuvant chemotherapy trials

Reporter/year	Regimen	Patients	Survival benefit
			Trial	Control
Songun/1999	FAMTX	Curat. Res.	15/271	18/29
Stahl/2009	PLF + rad. vs PLF	Curat. Res. (E-G J)	47.42	27.7
Schumacher/2010	PL	Curat. Res.	72.73	69.9

¹R0 surgery rate;

²Three year survival rate, P = NS;

³Two year survival rate. FAMTX: 5-FU + Adriamycin + Methotrexate; PLF + rad.: CDDP + Leucovorin + 5-FU and radiation; E-G J: Esophago-gastric junction; Curat. Res.: Curative resection.