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Abstract Purpose The survival benefits of neoadjuvant chemotherapy (NAC) for locally advanced gastric cancer (LAGC) patients are inconsistent. This study aims to investigate how different tumor regression grades (TRG) influence the survival gains associated with NAC treatment. Methods This study compared the treatment outcomes of patients who underwent CSC (neoadjuvant chemotherapy – surgery – adjuvant chemotherapy) with those receiving traditional SC (surgery – adjuvant chemotherapy) treatment. Propensity score matching (PSM) was employed to minimize potential biases arising from differences in baseline characteristics and intervention factors between the treatment groups. After PSM, the CSC cohort was stratified according to TRGs, and their survival outcomes were compared to assess the impact of TRGs on survival gains associated with NAC. Results Before PSM, a total of 506 patients were enrolled: 291 in the CSC cohort and 215 in the SC cohort. The CSC cohort had a lower 3-year survival rate (3Y-SR) than the SC cohort (64.6% vs. 76%). In the CSC cohort, patients who achieved pathological complete response (pCR, 12.1%, 26/215) demonstrated significantly improved 3Y-SR (95.5%). After PSM, 110 patients were matched in each cohort. The 3Y-SR was similar between the CSC cohort (68.3%) and the SC cohort (63.6%). In the CSC cohort, 12.7% (14/110) of patients achieved pCR. Subgroup analysis revealed that the pCR subgroup (3Y-SR 100%) was the only subgroup within the CSC cohort that maintained significantly improved survival compared to the SC cohort. Better tumor differentiation was the only pre-treatment factor significantly associated with achieving pCR (p

Background: Colorectal liver metastases (CLM) occur frequently and postoperative intestinal infection is a common complication. Our previous study showed that probiotics could decrease the rate of infectious complications after colectomy for colorectal cancer. To determine the effects of the perioperative administration of probiotics on serum zonulin levels which is a marker of intestinal permeability and the subsequent impact on postoperative infectious complications in patients with CLM. Methods: 150 patients with CLM were randomly divided into control group (n = 68) and probiotics group (n = 66). Probiotics and placebo were given orally for 6 days preoperatively and 10 days postoperatively to control group and probiotics group respectively. We used the local resection for metastatic tumor ,while for large tumor, the segmental hepatectomy. Postoperative outcome were recorded. Furthermore, complications in patients with normal intestinal barrier function and the relation with serum zonulin were analyzed to evaluate the impact on the liver barrier dysfunction. Results: The incidence of infectious complications in the probiotics group was lower than control group. Analysis of CLM patients with normal postoperative intestinal barrier function paralleled with the serum zonulin level. And probiotics could also reduce the concentration of serum zonulin (P = 0.004) and plasma endotoxin (P < 0.001). Conclusion: Perioperative probiotics treatment could reduce the serum zonulin level, the rate of postoperative septicemia and maintain the liver barrier in patients undergoing CLM surgery. we propose a new model about the regulation of probiotics to liver barrier via clinical regulatory pathway. We recommend the preoperative oral intake of probiotics combined with postoperative continued probiotics treatment in patients who undergo CLM surgery. Trial registration: ChiCTR-TRC-12002841. 2012/12/21 [ABSTRACT FROM AUTHOR]