Masaya Nakauchi1, Elvira Vos1, Laura H Tang2, Mithat Gonen3, Yelena Y Janjigian4, Geoffrey Y Ku4, David H Ilson4, Steven B Maron4, Sam S Yoon1, Murray F Brennan1, Daniel G Coit1, Vivian E Strong5. 1. Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 2. Gastrointestinal Pathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 5. Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. strongv@mskcc.org.
Abstract
BACKGROUND: This study aimed to analyze timing and sites of recurrence for patients receiving neoadjuvant chemotherapy for gastric cancer. Neoadjuvant chemotherapy followed by surgical resection is the standard treatment for locally advanced gastric cancer in the West, but limited information exists as to timing and patterns of recurrence in this setting. METHODS: Patients with clinical stage 2 or 3 gastric cancer treated with neoadjuvant chemotherapy followed by curative-intent resection between January 2000 and December 2015 were analyzed for 5-year recurrence-free survival (RFS) as well as timing and site of recurrence. RESULTS: Among 312 identified patients, 121 (38.8%) experienced recurrence during a median follow-up period of 46 months. The overall 5-year RFS rate was 58.9%, with RFS rates of 95.8% for ypT0N0, 81% for ypStage 1, 77.4% for ypStage 2, and 22.9% for ypStage 3. The first site of recurrence was peritoneal for 49.6%, distant (not peritoneal) for 45.5%, and locoregional for 11.6% of the patients. The majority of the recurrences (84.3%) occurred within 2 years. Multivariate analysis showed that ypT4 status was an independent predictor for recurrence within 1 year after surgery (odds ratio, 2.58; 95% confidence interval, 1.10-6.08; p = 0.030). CONCLUSIONS: The majority of the recurrences for patients with clinical stage 2 or 3 gastric cancer who received neoadjuvant chemotherapy and underwent curative resection occurred within 2 years. After neoadjuvant chemotherapy, pathologic T stage was a useful risk predictor for early recurrence.
BACKGROUND: This study aimed to analyze timing and sites of recurrence for patients receiving neoadjuvant chemotherapy for gastric cancer. Neoadjuvant chemotherapy followed by surgical resection is the standard treatment for locally advanced gastric cancer in the West, but limited information exists as to timing and patterns of recurrence in this setting. METHODS: Patients with clinical stage 2 or 3 gastric cancer treated with neoadjuvant chemotherapy followed by curative-intent resection between January 2000 and December 2015 were analyzed for 5-year recurrence-free survival (RFS) as well as timing and site of recurrence. RESULTS: Among 312 identified patients, 121 (38.8%) experienced recurrence during a median follow-up period of 46 months. The overall 5-year RFS rate was 58.9%, with RFS rates of 95.8% for ypT0N0, 81% for ypStage 1, 77.4% for ypStage 2, and 22.9% for ypStage 3. The first site of recurrence was peritoneal for 49.6%, distant (not peritoneal) for 45.5%, and locoregional for 11.6% of the patients. The majority of the recurrences (84.3%) occurred within 2 years. Multivariate analysis showed that ypT4 status was an independent predictor for recurrence within 1 year after surgery (odds ratio, 2.58; 95% confidence interval, 1.10-6.08; p = 0.030). CONCLUSIONS: The majority of the recurrences for patients with clinical stage 2 or 3 gastric cancer who received neoadjuvant chemotherapy and underwent curative resection occurred within 2 years. After neoadjuvant chemotherapy, pathologic T stage was a useful risk predictor for early recurrence.
Authors: Naruhiko Ikoma; Hsiang-Chun Chen; Xuemei Wang; Mariela Blum; Jeannelyn S Estrella; Keith Fournier; Paul Mansfield; Jaffer Ajani; Brian D Badgwell Journal: Ann Surg Oncol Date: 2017-03-22 Impact factor: 5.344
Authors: Salah-Eddin Al-Batran; Nils Homann; Claudia Pauligk; Thorsten O Goetze; Johannes Meiler; Stefan Kasper; Hans-Georg Kopp; Frank Mayer; Georg Martin Haag; Kim Luley; Udo Lindig; Wolff Schmiegel; Michael Pohl; Jan Stoehlmacher; Gunnar Folprecht; Stephan Probst; Nicole Prasnikar; Wolfgang Fischbach; Rolf Mahlberg; Jörg Trojan; Michael Koenigsmann; Uwe M Martens; Peter Thuss-Patience; Matthias Egger; Andreas Block; Volker Heinemann; Gerald Illerhaus; Markus Moehler; Michael Schenk; Frank Kullmann; Dirk M Behringer; Michael Heike; Daniel Pink; Christian Teschendorf; Carmen Löhr; Helga Bernhard; Gunter Schuch; Volker Rethwisch; Ludwig Fischer von Weikersthal; Jörg T Hartmann; Michael Kneba; Severin Daum; Karsten Schulmann; Jörg Weniger; Sebastian Belle; Timo Gaiser; Fuat S Oduncu; Martina Güntner; Wael Hozaeel; Alexander Reichart; Elke Jäger; Thomas Kraus; Stefan Mönig; Wolf O Bechstein; Martin Schuler; Harald Schmalenberg; Ralf D Hofheinz Journal: Lancet Date: 2019-04-11 Impact factor: 79.321
Authors: Florian Seyfried; Burkhard H von Rahden; Alexander D Miras; Martin Gasser; Uwe Maeder; Volker Kunzmann; Christoph-Thomas Germer; Jörg Pelz; Alexander G Kerscher Journal: BMC Cancer Date: 2015-02-19 Impact factor: 4.430
Authors: Paolo Aurello; Niccolò Petrucciani; Laura Antolino; Diego Giulitti; Francesco D'Angelo; Giovanni Ramacciato Journal: World J Gastroenterol Date: 2017-05-21 Impact factor: 5.742