Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
June 10, 2026 · via Europe PMC
Preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis: 3-year follow-up results from JCOG1704.
Kurokawa Y, Doki Y, Mizusawa J, +10 more, Yoshikawa T.
AI summary — for doctors, generated from the abstract only
Preoperative docetaxel, oxaliplatin, and S-1 achieved a 3-year overall survival of 86.7% in gastric cancer with extensive lymph node metastasis.
What was studied
The JCOG1704 single-arm phase II trial enrolled 47 patients with HER2-negative gastric cancer with bulky and/or para-aortic nodes who received three cycles of DOS, then D2 plus para-aortic dissection and adjuvant S-1.
Key findings
- 3-year OS 86.7% and PFS 75.6% among 46 eligible patients
- 3-year RFS 78.6% among 42 with R0 resection
- Para-aortic node-only subgroup had 3-year OS of 93.8%
- Patients with both bulky and para-aortic nodes had 3-year OS of 77.8%
Clinical relevance
The regimen was adopted as a provisional standard within the JCOG community, but single-arm phase II data in 47 patients lack a randomized comparator.
Who should care
Limitations
Small single-arm phase II trial without a direct comparator, in a Japanese population.
Intensive preoperative triplet chemotherapy shows strong survival results for extensively node-positive gastric cancer.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Prognosis of marginally resectable gastric cancer with extensive lymph node metastasis (ELM) remains poor, even after R0 resection. JCOG0405 established preoperative cisplatin plus S-1 as a provisional standard of care in Japanese guidelines, based on a favorable 3-year overall survival (OS) of 58.8%. We report the 3-year survival outcomes of JCOG1704, a phase II trial evaluating preoperative docetaxel, oxaliplatin, and S-1 (DOS) for marginally resectable gastric cancer with ELM, following promising short-term outcomes.
Methods
Patients with histologically confirmed HER2-negative gastric adenocarcinoma and bulky nodal (BN) involvement and/or para-aortic node (PAN) metastasis were eligible. Patients received three cycles of DOS (docetaxel 40 mg/m2, day 1; oxaliplatin 100 mg/m2, day 1; S-1 80-120 mg/m2, days 1-14) every 3 weeks, followed by gastrectomy with D2 plus PAN dissection and postoperative S-1 for 1 year.
Results
Between December 2018 and March 2022, 47 patients (BN only, 20; PAN only, 17; both, 10) were enrolled. At the data cutoff date (May 2025), the 3-year OS and progression-free survival (PFS) were 86.7% (95% CI 72.7-93.8%) and 75.6% (95% CI 60.2-85.6%), respectively, among 46 eligible patients. Among 42 patients who underwent R0 resection, the 3-year relapse-free survival (RFS) was 78.6% (95% CI 62.9-88.2%). In subgroup analyses, the 3-year OS/PFS/RFS were 85.0%/75.0%/77.8% in BN only, 93.8%/81.3%/86.7% in PAN only, and 77.8%/66.7%/66.7% in both.
Conclusions
Preoperative DOS for gastric cancer with ELM yielded unprecedentedly favorable 3-year survival outcomes and was considered a provisional standard of care without a phase III trial within our JCOG community.
DOI
10.1007/s10120-026-01766-3
PMID
42268543
PMCID
PMC13525059
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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