Timing of chemotherapy and survival in patients with resectable gastric adenocarcinoma

doi:10.4240/wjgs.v5.i12.321

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Dec 27, 2013; 5(12): 321-328
Published online Dec 27, 2013. doi: 10.4240/wjgs.v5.i12.321

Table 1 Comparison of the characteristics of the surgical groups n (%)

Characteristic		No chemon = 1191	Receivedchemotherapyn = 327	P value
Age, yr	Mean ± SD	71 ± 12	61 ± 14	< 0.0001
Sex	Men	741 (62)	221 (68)	0.0743
Sex	Women	450 (38)	106 (32)
Race/ ethnicity	Non-hispanic white	438 (37)	118 (36)	0.9833
	Black	112 (9)	33 (10)
	Hispanic white	322 (27)	88 (27)
	Asian/pacific islanders	319 (27)	88 (27)
Tumor location	Proximal	296 (25)	98 (30)	0.0290
	Distal	423 (36)	100 (31)
	Whole	167 (14)	59 (18)
	Middle	305 (26)	70 (21)
Grade	Well differentiated	26 (2)	1 (0)	0.0178
	Moderately differentiated	312 (26)	70 (21)
	Poorly differentiated	792 (66)	234 (72)
	Undifferentiated	40 (3)	18 (6)
	Unknown	21 (2)	4 (1)
Tumor size	≤ 5 cm	462 (39)	117 (36)	0.6048
	>5 cm	507 (43)	145 (44)
	Unknown	222 (19)	65 (20)
T stage¹	T2	108 (9)	24 (7)	0.1556
	T3	620 (52)	163 (50)
	T4a	319 (27)	96 (29)
	T4b	144 (12)	44 (13)
N stage¹	N0	334 (28)	38 (12)	< 0.0001
	N1	786 (66)	261 (80)
	N2	31 (3)	15 (5)
	N3	40 (3)	13 (4)
Node status	N-	334 (28)	38 (12)	< 0.0001
Node status	N+	857 (72)	289 (88)
AJCC7 group	II	767 (64)	187 (57)	0.0168
AJCC7 group	III	424 (36)	140 (43)

¹P values shown are based on the Jonckheere-Terpstra test for ordinal data. AJCC: American joint commission on cancer.

Table 2 Comparison of characteristics by chemotherapy groups n (%)

Characteristic		Neoadjuvantn = 37	Adjuvantn = 290	P value
Age, yr	Mean (± SD)	65 (± 10)	61 (± 14)	0.0583
Sex	Men	23 (62)	198 (68)	0.4543
Sex	Women	14 (38)	92 (32)
Race/ ethnicity	Non-hispanic white	18 (49)	100 (34)	0.2885
	Black	3 (8)	30 (10)
	Hispanic white	6 (16)	82 (28)
	Asian/pacific islanders	10 (27)	78 (27)
Tumor location	Proximal	12 (32)	86 (30)	0.9189
	Distal	10 (27)	90 (31)
	Whole	6 (16)	53 (18)
	Middle	9 (24)	61 (21)
Grade	Well differentiated	0 (0)	1 (0)	0.9087
	Moderately differentiated	7 (19)	63 (22)
	Poorly differentiated	27 (73)	207 (71)
	Undifferentiated	2 (5)	16 (6)
	Unknown	1 (3)	3 (1)
Tumor size	≤ 5 cm	10 (27)	107 (37)	0.2297
	> 5 cm	16 (43)	129 (44)
	Unknown	11 (30)	54 (19)
T stage¹	T2	0 (0)	24 (8)	0.4283
	T3	19 (51)	144 (50)
	T4a	15 (41)	81 (28)
	T4b	3 (8)	41 (14)
N stage¹	N0	7 (19)	31 (11)	0.2684
	N1	27 (73)	234 (81)
	N2	1 (3)	14 (5)
	N3	2 (5)	11 (4)
Node status	N-	7 (19)	31 (11)	0.1413
Node status	N+	30 (81)	259 (89)
AJCC7 group	II	23 (62)	164 (57)	0.5160
AJCC7 group	III	14 (38)	126 (43)

¹P values shown are based on the Jonckheere-Terpstra test for ordinal data. AJCC: American joint commission on cancer.

Table 3 Univariate and multivariate analysis

Factor		n (%)	Univariate		Multivariate
Factor		n (%)	HR (95%CI)	P value	HR (95%CI)	P value
Chemo status¹	Neo-Adjuvant	37 (11)	-	-	-	-
	Adjuvant	290 (89)	0.95 (0.65-1.38)	0.7854	0.97 (0.67-1.43)	0.8961
Age¹, yr	Mean ± SD	61.5 ± 14	1.02 (1.01-1.03)	0.0008	1.02 (1.01-1.03)	0.0006
Sex	Men	221 (68)	-	-
Sex	Women	106 (32)	1.00 (0.77-1.31)	0.9859
Race/ethnicity	Non-hispanic white	118 (36)	-	-
	Black	33 (10)	1.48 (0.96-2.27)	0.0765
	Hispanic white	88 (27)	1.16 (0.84-1.59)	0.3576
	Asian/pacific islanders	88 (27)	1.00 (0.73-1.37)	1.0000
Tumor location	Proximal	98 (30)	-	-
	Distal	100 (31)	0.90 (0.65-1.24)	0.5173
	Whole	59 (18)	0.99 (0.69-1.43)	0.9621
	Middle	70 (21)	0.94 (0.67-1.33)	0.7395
Grade	Well differentiated	1 (0)	-	-
	Moderately differentiated	70 (21)	0.38 (0.05-2.73)	0.3338
	Poorly differentiated	234 (72)	0.48 (0.07-3.43)	0.4642
	Undifferentiated	18 (6)	0.57 (0.07-4.31)	0.5843
	Unknown	4 (1)	0.41 (0.04-4.55)	0.4687
Tumor size	≤ 5cm	117 (36)	-	-
	> 5cm	145 (44)	1.33 (1.02-1.75)	0.0379
	Unknown	65 (20)	0.98 (0.66-1.46)	0.9322
T stage	T2	24 (7)	-	-
	T3	163 (50)	2.18 (1.17-4.05)	0.0135
	T4a	96 (29)	2.90 (1.54-5.45)	0.0009
	T4b	44 (13)	4.86 (2.48-9.53)	< 0.0001
N stage	N0	38 (12)	-	-
	N1	261 (80)	1.47 (0.99-2.20)	0.0588
	N2	15 (5)	1.98 (0.95-4.11)	0.0666
	N3	13 (4)	1.90 (0.94-3.84)	0.0731
Node status	N-	38 (12)	-	-
Node status	N+	289 (88)	1.51 (1.01-2.25)	0.0449
AJCC7 group¹	II	187 (57)	-	-	-	-
AJCC7 group¹	III	140 (43)	1.79 (1.39-2.30)	< 0.0001	1.81 (1.41-2.33)	< 0.0001

¹Included in multivariate model. AJCC: American joint commission on cancer; Chemo: Chemotherapy.

Citation: Arrington AK, Nelson R, Patel SS, Luu C, Ko M, Garcia-Aguilar J, Kim J. Timing of chemotherapy and survival in patients with resectable gastric adenocarcinoma. World J Gastrointest Surg 2013; 5(12): 321-328
URL: https://www.wjgnet.com/1948-9366/full/v5/i12/321.htm
DOI: https://dx.doi.org/10.4240/wjgs.v5.i12.321