1. Histopathologic response in patients with curative resection with D2 dissection following neoadjuvant treatment for locally advanced gastric and esophagogastric junction adenocarcinoma.
- Author
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Alemdar A, Duman MG, Sengiz Erhan S, and Sasako M
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Retrospective Studies, Survival Rate, Neoplasm Staging, Adult, Stomach Neoplasms pathology, Stomach Neoplasms surgery, Stomach Neoplasms therapy, Esophagogastric Junction pathology, Esophagogastric Junction surgery, Adenocarcinoma pathology, Adenocarcinoma surgery, Adenocarcinoma therapy, Neoadjuvant Therapy, Gastrectomy methods, Esophageal Neoplasms pathology, Esophageal Neoplasms therapy, Esophageal Neoplasms surgery, Lymph Node Excision, Postoperative Complications epidemiology
- Abstract
Aim: This study evaluated pathologic response rate, overall survival (OS), and postoperative complications in locally advanced gastric cancer (GC) and esophagogastric junction (EGJ) adenocarcinoma patients who underwent curative gastric resection D2 lymph node dissection with neoadjuvant treatment., Methods: We reviewed the medical records of 122 patients with locally advanced GC and EGJ adenocarcinoma who had neoadjuvant treatment and curative resection with D2 dissection between January 2014 and December 2022. Patients were divided into responders and nonresponders. Grades 1a-1b were responders, while 2-3 were non-responders. Patients' clinicopathological features, pathologic response rate, survival, and postoperative complications were evaluated. We assessed complications using the Clavien-Dindo (CD) classification. Total survival was assessed using the Kaplan-Meier model. Overall survival was assessed using univariate and multivariate Cox regression analysis., Results: The mean age of the study participants was 61 (N = 89 males; N = 33 females). There were 79 GC and 43 EGJ adenocarcinomas. Overall postoperative complications (CD ≥ II) were 27 %. Postoperative complications were similar in responders and non-responders (p = 0.316). YpT0N0 had a 2.5 % pathological complete response rate. Responders had better overall survival, but there was no statistical difference., Conclusions: Both responder and non-responder groups have similar postoperative complications. A complete pathologic response is discouraging for assessing neoadjuvant chemotherapy for locally advanced gastric cancer, but a positive treatment response is acceptable. Pathologic response rate helps stage and predict gastric cancer prognosis. Responder groups survive slightly better., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Journal name] and was not involved in the editorial review or the decision to publish this article., (© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
- Published
- 2024
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