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Purpose <p>This study aimed to clarify the significance of the relative dose intensity (RDI) of S-1 adjuvant chemotherapy (ACT) after gastrectomy in elderly patients with stage II/III gastric cancer (GC) and to determine whether the cachexia index (CXI) correlates with RDI.</p> Methods <p>We enrolled 76 patients with stage II/III GC, aged &gt; 70&#xa0;years. The overall survival (OS) and disease-specific survival (DSS) of participants in the surgery alone, S-1 ACT completion (RDI ≥ 58%), and S-1 ACT non-completion (RDI &lt; 58%) groups were compared. In addition, the clinicopathological determinants of RDI were examined.</p> Results <p>The <b>S-</b>1 ACT completion group had better OS and DSS, while the prognoses of patients in the surgery alone and S-1 ACT non-completion groups did not differ significantly. S-1 ACT non-completion or surgery alone was identified as an independent poor prognostic factor for OS and DSS. Furthermore, a multivariate analysis revealed that a high preoperative CXI (≥ 75.5 for males and ≥ 79.4 for females) was an independent predictor of success in achieving an RDI ≥ 58%.</p> Conclusions <p>A higher preoperative CXI can result in a higher RDI and improve the prognosis of elderly patients with stage II/III GC who underwent S-1 ACT.</p>

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A higher preoperative cachexia index can result in the sufficient administration of S-1 adjuvant chemotherapy and lead to a good prognosis for elderly patients with stage II/III gastric cancer

  • 期刊论文

  • 发表日期：

    2025年4月16日

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  • Kozo Miyatani,
  • Tomohiro Takahashi,
  • Shota Shimizu,
  • Yuji Shishido,
  • Takehiko Hanaki,
  • Kyoichi Kihara,
  • Tomoyuki Matsunaga,
  • Manabu Yamamoto,
  • Naruo Tokuyasu,
  • Shuichi Takano,
  • Teruhisa Sakamoto,
  • Toshimichi Hasegawa,
  • Hiroaki Saito,
  • Yoshiyuki Fujiwara

摘要

Purpose

This study aimed to clarify the significance of the relative dose intensity (RDI) of S-1 adjuvant chemotherapy (ACT) after gastrectomy in elderly patients with stage II/III gastric cancer (GC) and to determine whether the cachexia index (CXI) correlates with RDI.

Methods

We enrolled 76 patients with stage II/III GC, aged > 70 years. The overall survival (OS) and disease-specific survival (DSS) of participants in the surgery alone, S-1 ACT completion (RDI ≥ 58%), and S-1 ACT non-completion (RDI < 58%) groups were compared. In addition, the clinicopathological determinants of RDI were examined.

Results

The S-1 ACT completion group had better OS and DSS, while the prognoses of patients in the surgery alone and S-1 ACT non-completion groups did not differ significantly. S-1 ACT non-completion or surgery alone was identified as an independent poor prognostic factor for OS and DSS. Furthermore, a multivariate analysis revealed that a high preoperative CXI (≥ 75.5 for males and ≥ 79.4 for females) was an independent predictor of success in achieving an RDI ≥ 58%.

Conclusions

A higher preoperative CXI can result in a higher RDI and improve the prognosis of elderly patients with stage II/III GC who underwent S-1 ACT.