Prognostic impact of number of adjuvant chemotherapy cycles after neoadjuvant chemotherapy and surgery for node-negative gastric cancer

A multicenter retrospective study in China evaluated the prognostic impact of number of adjuvant chemotherapy cycles after neoadjuvant chemotherapy and surgery for node-negative gastric cancer. Patients who received at least five cycles of adjuvant chemotherapy had significantly longer overall survival compared with patients who received less than five cycles (3-year OS rate 86.8% versis 68.1%; p=0.016). Factors independently associated with 3-year OS in multivariate analyses were at least five cycles adjuvant chemotherapy (HR 0.367; p=0.014), ypT stage ≥ 2 (HR 2.779; p=0.017), and poorly differentiated tumors (HR 2.501, p=0.002). Stratified analyses found that at least five cycles of adjuvant chemotherapy (versus four or less cycles) was associated with improved 3-year OS rate among patients with ypT stage ≥2 (82.5% versus 62.6%; p=0.025) and among patients with poorly differentiated tumors (82.6% versus 53.3%; p=0.021). The authors conclude that after neoadjuvant chemotherapy and surgery, patients with lymph node-negative gastric cancer may benefit from at least five cycles of adjuvant chemotherapy.