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04-05-2024 | Gastric Cancer | Research

Prognostic Impact of Post-operative Infectious Complications in Gastric Cancer Patients Receiving Neoadjuvant Chemotherapy: Post Hoc Analysis of a Randomized Controlled Trial, JCOG0501

Authors: Masato Hayashi, Takaki Yoshikawa, Junki Mizusawa, Shinji Hato, Yoshiaki Iwasaki, Mitsuru Sasako, Yasuyuki Kawachi, Hiroyasu Iishi, Yasuhiro Choda, Narikazu Boku, Masanori Terashima

Published in: Journal of Gastrointestinal Cancer

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Abstract

Purpose

Post-operative infectious complication (IC) is a well-known negative prognostic factor, while showing neoadjuvant chemotherapy (NAC) may cancel out the negative influence of IC. This analysis compared the clinical impacts of IC according to the presence or absence of NAC in gastric cancer patients enrolled in the phase III clinical trial (JCOG0501) which compared upfront surgery (arm A) and NAC followed by surgery (arm B) in type 4 and large type 3 gastric cancer.

Methods

The subjects were 224 patients who underwent R0 resection out of 316 patients enrolled in JCOG0501. The prognoses of the patients with or without ICs in each arm were investigated by univariable and multivariable Cox regression analyses.

Results

There were 21 (20.0%) IC occurrences in arm A and 15 (12.6%) in arm B. In arm A, the overall survival (OS) of patients with ICs was slightly worse than those without IC (3-year OS, 57.1% in patients with ICs, 79.8% in those without ICs; adjusted hazard ratio (95% confidence interval), 1.292 (0.655–2.546)). In arm B, patients with ICs showed a trend of better survival than those without ICs (3-year OS, 80.0% in patients with IC, 74.0% in those without IC; adjusted hazard ratio, 0.573 (0.226–1.456)).

Conclusion

This study could not indicate the negative prognostic influence of ICs in gastric cancer patients receiving NAC, which might be canceled by NAC. To build exact evidence, further investigation with prospective and large numbers of data might be expected.
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Metadata
Title
Prognostic Impact of Post-operative Infectious Complications in Gastric Cancer Patients Receiving Neoadjuvant Chemotherapy: Post Hoc Analysis of a Randomized Controlled Trial, JCOG0501
Authors
Masato Hayashi
Takaki Yoshikawa
Junki Mizusawa
Shinji Hato
Yoshiaki Iwasaki
Mitsuru Sasako
Yasuyuki Kawachi
Hiroyasu Iishi
Yasuhiro Choda
Narikazu Boku
Masanori Terashima
Publication date
04-05-2024
Publisher
Springer US
Published in
Journal of Gastrointestinal Cancer
Print ISSN: 1941-6628
Electronic ISSN: 1941-6636
DOI
https://doi.org/10.1007/s12029-024-01061-3
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