Recurrence type-oriented adjuvant chemotherapy for gastric cancer

We have attempted to develop a new adjuvant chemotherapy system for gastric cancer patients corresponding to individual risk of the recurrence. To seek a reliable indicator and an effective regimen, multivariate analysis was performed in 1453 gastric cancer patients. Peritoneal and hematogenous recurrences has been shown to be predicted quantitatively by carcinoembryonic antigen level in peritoneal washing (>=100 ng/g protein) and 92KD type IV collagenase level in serum (>=100 ng/ml), and to be prevented by PF therapy (CDDP i.p.+ fluoropyrimidines) and MF therapy (MMC i.v.+fluoropyrimidines), respectively. Retrospective analysis showed the advantage in survival for stage III patients, wile received optimal treatment including no-therapy corresponding to the determination of recurrence risk. The therapy system may improve prognosis of gastric cancer patients through the selection of proper candidates and promising regimen.