Postoperative Adjuvant Immunochemotherapy with Mitomycin Futraful and PSK for Gastric Cancer. An Analysis of Data on 579 Patients Followed for Five Years

Authors: M Niimoto, T Hattori, R Tamada, K Sugimachi, K Inokuchi, N Ogawa

Journal: Japanese Journal of Surgery

Study Design: Randomized controlled trial

• Participants: 579 patients with curatively resected gastric cancer
• Intervention:
  • All patients received Mitomycin C (MMC) post-surgery
  • Group A: PSK (3g/day orally) for 1 year
  • Group B: Futraful (FT) (600-800mg/day orally) for 1 year
  • Group C: PSK + FT for 1 year
• Primary Outcomes: 5-year survival rates
  

Summary: The study demonstrated that the addition of PSK to the standard MMC + FT regimen significantly enhanced the 5-year survival rates for patients who had undergone curative gastrectomy for gastric cancer. The 5-year survival rate for the MMC + FT + PSK group was 71.7%, notably higher than the 64.1% and 58.5% observed in the PSK-only and FT-only groups, respectively. The benefit of adding PSK was particularly evident in patients with more advanced disease, such as those with positive lymph node metastases (57.4% vs 43.5% in the FT-only group) or serosal invasion (42% vs 27.9% in the FT-only group). Furthermore, the positive impact of PSK was also significant in patients with undifferentiated carcinoma (71.7% vs 56.6% in the FT-only group) and those with a preoperative positive PPD reaction (77.4% vs 58.9% in the PSK-only group). The study underscores the potential of PSK as a valuable addition to adjuvant immunochemotherapy regimens in gastric cancer treatment, especially for patients with poorer prognostic factors.