Lymph node regression after neoadjuvant chemotherapy: A predictor of survival in gastric cancer.

Abstract:

BACKGROUND AND OBJECTIVE:Neoadjuvant chemotherapy (nCMT) has been increasingly used in advanced gastric cancer (GC). However, the prognostic impact of tumor response remains unclear. This study aimed to evaluate if tumor response at the primary site and lymph nodes (LN) correlate with survival in GC patients after nCMT. METHODS:Patients with gastric adenocarcinoma treated with nCMT followed by gastrectomy were evaluated. Residual tumor was graded from 0% to 100%, defining two groups: poor (PR) and major response (MR). LN regression rate (LNRR) was determined based on tumor/fibrosis examination at each LN and a cutoff value established by receiver operating characteristic curve. RESULTS:Among 62 cases, 20 (32.2%) had MR and 42 (67.7%) PR. Smaller size, diffuse histology, lower ypT status and less advanced stage were associated with the MR group. Based on cutoff value of 57, 45.6% and 54.4% patients were classified as low-LNRR and high-LNRR. High-LNRR correlated with absence of venous, lymphatic and perineural invasion, and less advanced stage. Survival was equivalent between MR and PR (P = .956). High-LNRR had better disease-free survival (DFS) than low-LNRR (P < .001). In multivariate analysis, only LNRR associated with DFS. CONCLUSION:High-LNRR associates with DFS in GC treated with nCMT. Response at the primary site does not correlate with survival.

journal_name

J Surg Oncol

authors

Pereira MA,Ramos MFKP,Dias AR,Cardili L,Ribeiro RRE,Charruf AZ,de Castria TB,Zilberstein B,Ceconello I,Avancini Ferreira Alves V,Ribeiro U Jr,de Mello ES

doi

10.1002/jso.25785

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

795-803

issue

5

eissn

0022-4790

issn

1096-9098

journal_volume

121

pub_type

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