The Clinical Features And The Effect Of Adjuvant Chemotherapy In Gastric Cancer Based On Lauren Classification

Background and Objective:Lauren classification is a histological type of gastric cancer. A number of studies have reported that gastric cancer patients with different Lauren classifications have correlations between age, gender, tumor size, lymph node metastasis and recurrence. However, there is no obviously report that clarifing the correlation of Lauren classification and related treatments. This study was to investigate the clinical features of Lauren classification in gastric cancer patients at stage Ⅱ/Ⅲ, and find out the optimal adjuvant chemotherapy regimens according to the Lauren classification.Methods:Clinical datas of the patients with gastric cancer were collected based on the inclusion and exclusion criteria. The correlations were analysised between Lauren classification and clinical features. The primary endpoint was overall survival (OS), the secondary end point was disease-free survival (DFS). Survival curves were calculated by Kaplan Meier analysis. The difference of OS or DFS beween Lauren classification were analyzed by the log-rank test. The correlation between various factors and OS was analyzed by multivariate COX regression analysis.Results:Intestinal type occurs in older men, characteristed with well differentiated tumor tissue, earlier N stage, less lymph nodules metastasis. Diffuse type occurs in young women, characteristed with poor differentiated tumor tissue, later N stage. And mixed type has both characteristes of former two types. Neither Lauren classification nor adjuvant chemotherapy regimens has significant difference in OS and DFS. While, the OS and DFS of the intestinal type patients receiving5-FU+platinum-based chemotherapy were significantly longer than S-1+platinum-based adjuvant chemotherapy. The OS and DFS of the diffuse type patients receiving5-FU+platinum-based chemotherapy were significantly shorter than S-1+platinum-based adjuvant chemotherapy. The DFS of the mixed type patients receiving5-FU+platinum-based chemotherapy were significantly shorter than S-1+platinum-based adjuvant chemotherapy, however, the OS didn’t have significant difference.Conclusion:Lauren classification has its unique clinical features and is an independent prognostic indicator of gastric cancer patients, because of the OS of intestinal type and diffuse type were significantly longer than diffuse type. Intestinal type gastric cancer patients should receive5-FU+platinum-based chemotherapy after surgery; while, mixed type and diffuse type of gastric cancer patients should receive S-1+platinum-based adjuvant chemotherapy.