Yi Wang1,2,3,4, Handong Xu1,2,3,4, Can Hu1,2,3,4, Pengcheng Yu1,2,3,4, Zhehan Bao1,2,3,4, Yanqiang Zhang2,3,4, Ruolan Zhang1,2,3,4, Shengjie Zhang2,3,4, Bing Li5, Jean-Marie Aerts6, Zhiyuan Xu2,3,4, Xiangdong Cheng2,3,4. 1. The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China. 2. Department of Gastric Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institutes of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China. 3. Diagnosis and Therapy Center of Upper Gastrointestinal Tumor in Zhejiang Province, Hangzhou, China. 4. International Cooperation Base for Cancer Molecular Diagnosis and Intelligent Screening of Zhejiang Province, Hangzhou, China. 5. Leuven Health Technology Centre China Centre, Hangzhou, China. 6. Department of Biosystems, Division Animal and Human Health Engineering, KU Leuven, Leuven, Belgium.
Abstract
Background: Neoadjuvant chemotherapy (NACT) and radical gastrectomy are the gold standard treatments for resectable advanced gastric cancer (GC). However, the prognostic value of the pathological tumor regression grade (TRG) of NACT remains controversial. This retrospective study aimed to investigate the correlation between the TRG after NACT and clinicopathological features as well as its prognostic value in advanced GC. Methods: In total, 551 patients with GC who received NACT combined with surgical resection at the Zhejiang Cancer Hospital from April 2004 to December 2019 were included. The demographic characteristics, treatment response, tumor characteristics, treatment regimens, and survival data were reviewed from the medical records of all patients. The Chi-square test was used to analyze the correlation between TRG and clinicopathological factors. Kaplan-Meier univariate analysis and Cox regression multivariate analysis were used to determine the independent risk factors affecting the prognosis of GC patients. Results: Among the 551 patients with advanced GC who accepted NACT treatment, 14 were determined to be in TRG 0, 98 in TRG 1, 257 in TRG 2, and 182 in TRG 3. Also, TRG was significantly correlated with the cT stage (P=0.015), ypT stage (P<0.001), ypN stage (P<0.001), ypTNM stage (P<0.001), vascular tumor thrombus (P<0.001), Borrmann classification (P=0.042), and lymph node ratio (LNR) (P<0.001). Furthermore, patients who had a good pathological response to NACT had a better prognosis, with a 3-year overall survival (OS) of 70.9% versus 48.8% in patients who had a poor pathological response. We also found that TRG (P=0.042, HR =1.65) was an independent prognostic factor affecting the OS of GC patients. Conclusions: TRG plays a significant role in the prognostic value in neoadjuvant chemotherapy for gastric adenocarcinoma. Patients with higher cT stage, higher levels of pre-CA199 and pre-CA125 may have worse pathological response. 2022 Journal of Gastrointestinal Oncology. All rights reserved.
Background: Neoadjuvant chemotherapy (NACT) and radical gastrectomy are the gold standard treatments for resectable advanced gastric cancer (GC). However, the prognostic value of the pathological tumor regression grade (TRG) of NACT remains controversial. This retrospective study aimed to investigate the correlation between the TRG after NACT and clinicopathological features as well as its prognostic value in advanced GC. Methods: In total, 551 patients with GC who received NACT combined with surgical resection at the Zhejiang Cancer Hospital from April 2004 to December 2019 were included. The demographic characteristics, treatment response, tumor characteristics, treatment regimens, and survival data were reviewed from the medical records of all patients. The Chi-square test was used to analyze the correlation between TRG and clinicopathological factors. Kaplan-Meier univariate analysis and Cox regression multivariate analysis were used to determine the independent risk factors affecting the prognosis of GC patients. Results: Among the 551 patients with advanced GC who accepted NACT treatment, 14 were determined to be in TRG 0, 98 in TRG 1, 257 in TRG 2, and 182 in TRG 3. Also, TRG was significantly correlated with the cT stage (P=0.015), ypT stage (P<0.001), ypN stage (P<0.001), ypTNM stage (P<0.001), vascular tumor thrombus (P<0.001), Borrmann classification (P=0.042), and lymph node ratio (LNR) (P<0.001). Furthermore, patients who had a good pathological response to NACT had a better prognosis, with a 3-year overall survival (OS) of 70.9% versus 48.8% in patients who had a poor pathological response. We also found that TRG (P=0.042, HR =1.65) was an independent prognostic factor affecting the OS of GC patients. Conclusions: TRG plays a significant role in the prognostic value in neoadjuvant chemotherapy for gastric adenocarcinoma. Patients with higher cT stage, higher levels of pre-CA199 and pre-CA125 may have worse pathological response. 2022 Journal of Gastrointestinal Oncology. All rights reserved.
Authors: G Tomasello; F Petrelli; M Ghidini; E Pezzica; R Passalacqua; F Steccanella; L Turati; G Sgroi; S Barni Journal: Eur J Surg Oncol Date: 2017-03-18 Impact factor: 4.424
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Authors: Paola Germani; Francesca Di Candido; Daniel Léonard; Dajana Cuicchi; Ugo Elmore; Marco Ettore Allaix; Vittoria Pia Barbieri; Laura D'Allens; Seraina Faes; Marika Milani; Damiano Caputo; Carmen Martinez; Jan Grosek; Valerio Caracino; Niki Christou; Sapho X Roodbeen; Umberto Bracale; Aurelia Wildeboer; Antonella Usai; Michele Benedetti; Alessandro Balani; Giuseppe Piccinni; Marco Catarci; Paolo Millo; Nicole Bouvy; Francesco Corcione; Roel Hompes; Frédéric Ris; Massimo Basti; Ales Tomazic; Eduardo Targarona; Alessandro Coppola; Andrea Pietrabissa; Dieter Hahnloser; Michel Adamina; Massimo Viola; Mario Morino; Riccardo Rosati; Gilberto Poggioli; Alex Kartheuser; Antonino Spinelli; Nicolò de Manzini Journal: Updates Surg Date: 2021-04-05