ADVERTISEMENT
Is preoperative chemosensitivity associated with improved outcomes in locally advanced gastric cancer?
Background
Perioperative chemotherapy (PCT) is the standard of care for locally advanced gastric cancer (LAGC) in western countries. Less than 60% of patients complete the adjuvant part of treatment due to postoperative complications, toxicity and disease progression (DP). The aim of this study is to evaluate if preoperative chemosensitivity (POCS) is associated with improved overall survival (OS) and disease free survival (DFS).
Methods
Retrospective, unicentric study of 51 consecutive patients with LGAC treated with PCT and curative resection from 2015 to 2020. We defined POCS as sensitive (partial or complete pathological responses) and refractory (no pathological response or disease progression).
Results
51 medical records were reviewed. 7 patients were excluded because surgery was not performed due to DP. Median age was 63 years, 29 (65.9%) were male. All patients were ECOG 0-1. Regarding neoadjuvant chemotherapy, 26 patients (59%) received FLOT, 15 (34.1%) received ECF and 3 patients (6.9%) received EOF, EOX and FOLFOX. 19 patients (43.2%) were classified as refractory and 25 (56.8%) as sensitive (21 had partial pathological response and 4 had complete pathological response). 3 patients did not complete the preoperative therapy due to toxicity. Mean OS was 62.9 months (95% CI, 53.1-72.7) in the sensitive group versus 35.5 months (95% CI, 26.2-44.9; p=.036) in the refractory group. Mean DFS was 62.5 months (95% CI, 53.8-71.4) in the sensitive group versus 41.5 months (95% CI, 31.6-51.4; p=.297) in the refractory group.
Conclusions
Despite the limitations due to our sample size, preoperative chemosensitivity was associated with an improved OS in patients with LAGC treated with perioperative chemotherapy and surgery.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosures
All authors have declared no conflicts of interest.
