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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2019

Open Access 01-12-2019 | Gastric Cancer | Research

Pathological evaluation of neoadjuvant chemotherapy in advanced gastric cancer

Authors: Shen-Bao Hu, Chun-Hao Liu, Xiang Wang, Yun-Wei Dong, Lin Zhao, Hong-Feng Liu, Yue Cao, Ding-Rong Zhong, Wei Liu, Yan-Long Li, Wei-Sheng Gao, Chun-Mei Bai, Zhong-Hua Shang, Xiao-Yi Li

Published in: World Journal of Surgical Oncology | Issue 1/2019

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Abstract

Background

Although pathological evaluation has been considered an effective evaluation method, some problems still exist in practice. Therefore, we explored whether there are more reasonable and practical pathological evaluation criteria for neoadjuvant chemotherapy in patients with advanced gastric cancer. Here, we aim to determine pathological judgment criteria for neoadjuvant chemotherapy in patients with advanced gastric cancer.

Methods

Eighty-seven patients with cT2–4 or cN+ were enrolled in this study. Pathological factors for overall survival (OS) were investigated using univariate and multivariate analyses, and the pathological criteria for neoadjuvant chemotherapy were then determined.

Results

A total of 87 patients underwent 3–4 cycles of neoadjuvant chemotherapy, with 67 (77.0%), 15 (17.2%), and 5 (5.8%) receiving Folfox6, Xelox, and SOX regimens, respectively. All patients showed different levels of graded histological regression (GHR) of the primary tumor, with a ≥ 50% regression rate of 50.6%. The univariate analysis showed that GHR ≥ 50% (p = 0.022), 66.7% (p = 0.013), and 90% (p = 0.028) were significantly correlated with OS. The multivariate analysis demonstrated that ypTNM (II/III) stage was significantly associated with OS compared with ypTNM (0+I) stage [HR = 3.553, 95% CI 1.886–6.617; HR = 3.576, 95% CI 1.908–6.703, respectively] and that the Lauren classification of diffuse type was also an independent risk factor for OS compared with the intestinal type (HR = 3.843, 95% CI 1.443–10.237).

Conclusions

The Lauren classification and ypTNM stage after neoadjuvant chemotherapy are independent prognostic factors in advanced gastric cancer. A GHR ≥ 50%/< 50% can be used as the primary criterion for advanced gastric cancer after neoadjuvant chemotherapy to determine postoperative adjuvant chemotherapy regimens.
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Metadata
Title
Pathological evaluation of neoadjuvant chemotherapy in advanced gastric cancer
Authors
Shen-Bao Hu
Chun-Hao Liu
Xiang Wang
Yun-Wei Dong
Lin Zhao
Hong-Feng Liu
Yue Cao
Ding-Rong Zhong
Wei Liu
Yan-Long Li
Wei-Sheng Gao
Chun-Mei Bai
Zhong-Hua Shang
Xiao-Yi Li
Publication date
01-12-2019
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2019
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-018-1534-z

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