Impact of CINV and antiemetic use on completion of adjuvant chemotherapy after gastrectomy: a single-center retrospective study

Purpose: Chemotherapy-induced nausea and vomiting (CINV) is a major cause of noncompliance among patients undergoing adjuvant chemotherapy after gastrectomy.This study aimed to evaluate the impact of CINV and antiemetic use on the completion of planned chemotherapy in patients with gastric cancer.Materials and Methods: We retrospectively reviewed data from 74 patients who underwent gastrectomy followed by adjuvant capecitabine and oxaliplatin (CAPOX) chemotherapy between 2018 and 2024.CINV positivity was defined as patient-reported nausea or vomiting greater than grade 3 in severity according to Common Terminology Criteria for Adverse Events version 5.0 criteria.The primary endpoint was the completion of all 8 planned cycles of CAPOX chemotherapy.Clinical variables, including age, sex, American Society of Anesthesiologists (ASA) class, surgical approach, antiemetic regimen, and long-term survival data, were analyzed.Results: CINV occurred in 29 patients (39.2%), of whom 22 (75.9%) completed chemotherapy.Univariate logistic regression revealed a significant association between CINV and reduced chemotherapy completion (odds ratio, 0.22; P=0.042).Other clinical variables, including age, ASA class, surgical approach, and reconstruction method, were not significantly associated with treatment completion.Patients who completed chemotherapy had significantly better overall survival than those who did not (P=0.007).There was no significant difference in relapse-free survival between the groups (P=0.722).Conclusions: CINV was significantly associated with a lower likelihood of completing adjuvant chemotherapy in patients with gastric cancer.Early identification and proactive management of CINV may play a critical role in supporting patients through the full course of adjuvant therapy.