Hyung-Don Kim1, Jong Seok Lee2, Young Soo Park3, Jeong Hwan Yook4, Sung Hoon Noh5, Young-Kyu Park6, Young-Woo Kim7, Sang Cheul Oh8, Jong Gwang Kim9, Min-Hee Ryu1, Jae-Ho Cheong5, HyunKi Kim10, Joon Seok Lim11, Jae-Hyuk Lee12, Suk Hee Heo13, Jin Young Kim14, Mi Hwa Heo14, Young Iee Park7, In-Ho Kim15, Yoon-Koo Kang16. 1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. 2. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 4. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 5. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. 6. Department of Surgery, Chonnam National University Medical School, Hwasun, Republic of Korea. 7. Center for Gastric Cancer, Graduate School of Cancer Science and Policy, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. 8. Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea. 9. Department of Internal Medicine, Kyungpook National University, Daegu, Republic of Korea. 10. Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 11. Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 12. Department of Pathology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, South Korea. 13. Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, South Korea. 14. Division of Hemato-Oncology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea. 15. Division of Medical Oncology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. 16. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. ykkang@amc.seoul.kr.
Abstract
BACKGROUND: In this post hoc analysis of the PRODIGY study, we aimed to investigate factors associated with survival outcomes and provide evidence for designing optimal perioperative treatment strategies for gastric cancer patients receiving neoadjuvant chemotherapy. PATIENTS AND METHODS: A total of 212 patients in the neoadjuvant chemotherapy group of the PRODIGY study were included as the study population. The prognostic impact of clinicopathologic factors, including the initial radiological clinical stage (cStage) and post-neoadjuvant chemotherapy pathological stage (ypStage), was analyzed. RESULTS: The median age was 58 years. The majority of patients (77.4%) had cStage III disease, and about 10% and 25% had ypStage 0 and I disease, respectively. According to the initial cStage, progression-free survival (PFS) and overall survival (OS) were significantly different (P < 0.01). PFS and OS were also different according to the ypStage (P < 0.01). In multivariate analyses, cStage IIIC disease (vs. cStage II) and ypStage II and III disease (vs. ypStage 0/I) were independent factors for poor survival outcomes. Based on the patterns of PFS and OS according to both cStage and ypStage, three patient groups were defined. These groups showed distinct PFS and OS (P < 0.01) with 5-year PFS rates of 95.7%, 77.9%, and 31.3% and 5-year OS rates of 95.7%, 82.4%, and 42.5%, respectively. CONCLUSIONS: Both initial cStage and ypStage were independent factors for survival outcomes of gastric cancer patients treated with neoadjuvant chemotherapy. Efforts should be made to develop optimal peri-operative treatment strategies for patients at different risks according to cStage and ypStage.
BACKGROUND: In this post hoc analysis of the PRODIGY study, we aimed to investigate factors associated with survival outcomes and provide evidence for designing optimal perioperative treatment strategies for gastric cancer patients receiving neoadjuvant chemotherapy. PATIENTS AND METHODS: A total of 212 patients in the neoadjuvant chemotherapy group of the PRODIGY study were included as the study population. The prognostic impact of clinicopathologic factors, including the initial radiological clinical stage (cStage) and post-neoadjuvant chemotherapy pathological stage (ypStage), was analyzed. RESULTS: The median age was 58 years. The majority of patients (77.4%) had cStage III disease, and about 10% and 25% had ypStage 0 and I disease, respectively. According to the initial cStage, progression-free survival (PFS) and overall survival (OS) were significantly different (P < 0.01). PFS and OS were also different according to the ypStage (P < 0.01). In multivariate analyses, cStage IIIC disease (vs. cStage II) and ypStage II and III disease (vs. ypStage 0/I) were independent factors for poor survival outcomes. Based on the patterns of PFS and OS according to both cStage and ypStage, three patient groups were defined. These groups showed distinct PFS and OS (P < 0.01) with 5-year PFS rates of 95.7%, 77.9%, and 31.3% and 5-year OS rates of 95.7%, 82.4%, and 42.5%, respectively. CONCLUSIONS: Both initial cStage and ypStage were independent factors for survival outcomes of gastric cancer patients treated with neoadjuvant chemotherapy. Efforts should be made to develop optimal peri-operative treatment strategies for patients at different risks according to cStage and ypStage.
Authors: J S Macdonald; S R Smalley; J Benedetti; S A Hundahl; N C Estes; G N Stemmermann; D G Haller; J A Ajani; L L Gunderson; J M Jessup; J A Martenson Journal: N Engl J Med Date: 2001-09-06 Impact factor: 91.245
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Authors: Yoon-Koo Kang; Jeong Hwan Yook; Young-Kyu Park; Jong Seok Lee; Young-Woo Kim; Jin Young Kim; Min-Hee Ryu; Sun Young Rha; Ik Joo Chung; In-Ho Kim; Sang Cheul Oh; Young Soo Park; Taeil Son; Mi Ran Jung; Mi Hwa Heo; Hark Kyun Kim; ChoHyun Park; Chang Hak Yoo; Jin-Hyuk Choi; Dae Young Zang; You Jin Jang; Ji Young Sul; Jong Gwang Kim; Beom Su Kim; Seung-Hoon Beom; Sang Hee Cho; Seung Wan Ryu; Myeong-Cherl Kook; Baek-Yeol Ryoo; Hyun Ki Kim; Moon-Won Yoo; Nam Su Lee; Sang Ho Lee; Gyunji Kim; YeonJu Lee; Jee Hyun Lee; Sung Hoon Noh Journal: J Clin Oncol Date: 2021-06-16 Impact factor: 50.717