Long-term follow-up study of gastric cancer patients treated with surgery and adjuvant chemotherapy with mitomycin C

Abstract

A group of 496 cases was used in a controlled trial to study the possible value of mitomycin C as an adjuvant to curative surgery for gastric cancer. Patients assigned to receive the drug were given mitomycin C, 0.8 mg/kg body weight intravenously, twice a week for 5 weeks immediately after surgery. The control group was treated with surgery alone. Sixty-six patients were excluded from the study because of non-curative surgery. There was no over-all difference in survival and cancer death rates at 5 and 10 years between treated and control groups. However, a survival rate 18.6% higher at 5 years was observed in the subset of patients who had moderately advanced lymphatic metastases, and a survival rate 26.4% higher at 5 years was observed in the subset of patients who had involved serosa. The difference in cancer death rate was 14.5 and 24.0% in each subset, respectively. These significant differences persisted at 10 years. The effect of chemotherapy seemed to result from the successful inhibition of peritoneal dissemination and local recurrence. An adverse effect was observed in patients in the early stages cancer. These results suggest that mitomycin C could be useful as an adjuvant to curative surgery for moderately advanced stages of gastric cancer.