Adjuvant Chemotherapy with Mitomycin C, and with a Multi-drug Combination of Mitomycin C, 5-Fluorouracil and Cytosine Arabinoside after Curative Resection of Gastric Cancer

In an attempt to evaluate the adjuvant effect of mitomycin C (MMC) and a combination of MMC, 5-fluorouracil (5-Fu) and cytosine arabinoside (Ara-C) after curative resection of stomach carcinoma, 126 cases were entered into an adjuvant chemotherapy program. The patients were divided into three groups randomly. Group A (42 patients) received 0.08 mg of MMC per kg intravenously twice a week for five weeks. Group B (40 patients) received a combination of 0.04 mg of MMC, 5 mg of 5-Fu and 0.4 mg of Ara-C per kg intravenously twice a week for five weeks. Group C (38 patients) received no additional therapy, and served as the control. Two patients were later eliminated from group B and four from group C as a result of violation of the protocols. There were no deaths from the drugs, but frequent liver dysfunction was observed during chemotherapy as a result of toxic effects on the liver under the influence of anesthesia and surgical intervention. The five year survival in the two treatment groups (A and B) was 64.3% and 66.9%, respectively, compared to 50.0% in the control group. The difference in survival between groups B and C was statistically significant (P<0.05). That between groups A and C was not significant, mainly because of the small number of cases. In relation to a variety of prognostic factors, the adjuvant effect of the chemotherapy was manifest among patients with moderately advanced disease rather than those with early stage disease.