AIM: To compare the efficacy of adjuvant chemotherapy regimens containing oxaliplatin or without oxaliplatin in pathological stage III gastric cancer patients after D2 resection.
METHODS: According to the AJCC gastric cancer TNM staging system (7th edition), the patients with pathological stage III gastric cancer who received adjuvant chemotherapy after D2 dissection were analyzed. A total of 307 patients, of whom 116 patients with intestinal type and 191 patients with diffuse type gastric cancer, were enrolled into this study. Disease free survival (DFS) and overall survival (OS) were compared among these groups.
RESULTS: The median DFS was 20.70 months, and the median OS was 44.77 months. The median DFS and OS in the diffuse type group were significantly lower than those in the intestinal type group (median DFS: 18.43 months vs. 27.27 months, P<0.001; median OS: 36.63 months vs. not reached, P=0.001). In subgroup analysis, the median DFS was 38.30 months in the oxaliplatin-based group which was higher than that (18.17 months) in the oxaliplatin-free group (P = 0.006) for intestinal type gastric cancer patients. But for diffuse type gastric cancer patients, the differences in PFS between two groups were not statistically significant (18.97 months vs. 16.47 months, P=0.134). In intestinal type, the median OS was not reached in the oxaliplatin-based group and 32.40 months in the oxaliplatin-free group (P = 0.001). But in diffuse type, the patients with oxaliplatin-based chemotherapy didn't have a significant better OS than the others receiving chemotherapy regimens without oxaliplatin (39.53 months vs. 28.17 months, P=0.224).
CONCLUSIONS: Adjuvant chemotherapy regimens containing oxaliplatin was more effective than those without oxaliplatin in intestinal type gastric cancer patients with pathological stage III after D2 gastrectomy. But oxaliplatin-based chemotherapy did not show any survival benefit compared with oxaliplatin-free chemotherapy in diffuse type.