Assessing the efficacy of adjuvant chemotherapy in patients with T3N0 gastric cancer
In brief
Adjuvant chemotherapy does not improve 5-year survival in T3N0 gastric cancer
In a retrospective cohort of 386 T3N0 patients, five-year overall survival was 93% with chemotherapy versus 91% with surgery alone, and relapse-free survival was similarly close. After statistical adjustment, chemotherapy showed no significant reduction in death or recurrence, leaving its routine use in this stage uncertain.
- Journal
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Q1)
- Published
- 10 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ki-Yoon Kim, Jawon Hwang, Sung Hyun Park, Minah Cho, Hyoung-Il Kim, Woo Jin Hyung, et al.
- PMID
- 42743602
- DOI
- 10.1016/j.ejso.2026.112122
Why clinicians should know about it
- Picked for Gastrointestinal and Colorectal Surgery (top studies of the week, 20 September 2026): Adjuvant chemo in T3N0 gastric cancer
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- Picked for Pathology and Forensic Medicine (top studies of the week, 20 September 2026): Adjuvant chemo gastric, no diagnostic pathology focus
Abstract
BACKGROUND: Adjuvant chemotherapy is standard for advanced gastric cancer based on randomized controlled trials. However, its effectiveness in patients with T3N0 stage, who were not included in these trials, remains unclear. This study assessed its clinical benefits by comparing outcomes between patients with T3N0 stage who received postoperative chemotherapy with those who did not. METHODS: From 2011 to 2019, a retrospective analysis was performed on 386 patients with pathologically diagnosed T3N0 advanced gastric cancer who underwent radical gastrectomy. Inverse probability of treatment weighting (IPTW) was used to analyze overall survival(OS) and relapse-free survival (RFS) between groups. RESULTS: Among 386 patients, 188 received adjuvant chemotherapy and 198 underwent surgery alone. After IPTW adjustment, the 5-year OS were 93.1 % in the adjuvant chemotherapy group and 91.3 % in the surgery-only group, and the 5-year RFS were 88.4 % and 84.4 %, respectively. Adjuvant chemotherapy was not associated with a significant reduction in the risk of death (hazard ratio [HR], 0.72; 95 % confidence interval [CI], 0.32-1.61; P = 0.428) or recurrence (HR, 0.68; 95 % CI, 0.34-1.34; P = 0.264). Overall recurrence rates and recurrence patterns were comparable between the two groups after adjustment. Among patients who received chemotherapy, grade III/IV adverse events occurred in 26.7 % of those treated with TS-1 and 70.4 % of those treated with XELOX. CONCLUSION: In patients with T3N0 stage after surgery, the chemotherapy group demonstrated OS and RFS similar to surgery-only group. Therefore, the benefit of adjuvant chemotherapy in patients with T3N0 gastric cancer remains uncertain.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.