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        The Effectiveness of Postoperative Chemotherapy on pT1bN0 and pT2N0 Gastric Cancer Patients with Risk Factors: An International Dual-Center Analysis

        Kun Yang,Mo-Xi Chen,최윤영,Zong-Guang Zhou,형우진,노성훈,Jian-Kun Hu 연세대학교의과대학 2021 Yonsei medical journal Vol.62 No.2

        Purpose: This study aimed to investigate the effectiveness of postoperative chemotherapy in pT1bN0 and pT2N0 gastric cancerpatients with high risk factors. Materials and Methods: Clinicopathological data of gastric cancer patients, who had undergone gastrectomy in high volumecenters in Korea and China and were finally diagnosed with pT1bN0 and pT2N0 between 2006 and 2010, were analyzed retrospectively. Survival analyses stratified by risk factors and multivariable analyses were performed. Results: A total of 1509 patients were enrolled, with 41 (2.7%) patients receiving adjuvant chemotherapy after gastrectomy and1468 (97.3%) patients undergoing surgery alone. The adjuvant chemotherapy group showed higher percentages of tumor withmaximal diameter >3 cm (51.2% vs. 25.8%), poor differentiation (68.3% vs. 49.8%), and less harvested lymph nodes (17.1% vs. 5.2%) compared to the surgery alone group. The overall survival rates were 95.1% in the adjuvant chemotherapy group and 93.3%in the surgery alone group, without significant difference. In multivariable analysis, age was found to be an independent prognosticfactor. However, there were no difference in the overall survival between patients with risk factors and those without risk factors,even in terms of age. Meanwhile, patients with more than two risk factors who received chemotherapy showed better survivaltrend, especially for pT2N0 patients, compared to the surgery alone group, although no significant differences were observed. Conclusion: In pT1bN0 and pT2N0 patients, age was found to be an independent prognostic factor. However, adjuvant chemotherapyseemed to be unnecessary, while postoperative chemotherapy might offer survival benefits to pT2N0 patients with morethan two risk factors.

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