Abstract

BackgroundTo demonstrate that post-therapy pathological tumor volume (ypTV) should be considered as an independent prognostic factor in advanced gastric cancer (GC) patients who underwent neoadjuvant chemotherapy (NAC) and gastrectomy.MethodsA total of 253 GC patients who received gastrectomy between January 2010 and December 2016 in our hospital were enrolled in this study. Clinicopathologic factors were evaluated using univariable and multivariable analysis. ypTV was calculated using π* (tumor diameter/2)2 *tumor invasion depth (cm3).ResultsCut-point survival analysis demonstrated that the appropriate cut-offs for ypTV were 3, 6, 10, and 19 (cm3). Patients with tumor volumes of 0–3.0, 3.1–6.0, 6.1–10.0, 10.1–19.0, ≥19.1 cm3 were defined as ypTV1, 2, 3, 4a and 4b. Using multivariable analysis, the tumor volume (ypTV stage, P < 0.05), ypN stage (P < 0.05), response to NAC (P < 0.05), vascular invasion (P < 0.05) and ypTvNM staging (P < 0.05) were independent prognostic factors. Kaplan-Meier analysis demonstrated that the 8th AJCC/UICC ypTNM staging was not a significant predictor for survival (P > 0.05); however, our newly defined ypTvNM staging was a significant predictor for survival (P < 0.05).ConclusionsypTV should be considered as an independent prognostic factor for GC patients after NAC. ypTvNM staging should be recommended to improve the accuracy of prognostic prediction for GC patients who received NAC plus gastrectomy.

Highlights

  • To demonstrate that post-therapy pathological tumor volume should be considered as an independent prognostic factor in advanced gastric cancer (GC) patients who underwent neoadjuvant chemotherapy (NAC) and gastrectomy

  • This study was designed to assess the potential impact of tumor volume on long-term survival of patients treated with neoadjuvant chemotherapy and gastrectomy for cancer

  • All patients enrolled in this study underwent gastrectomy with lymphadenectomy

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Summary

Introduction

To demonstrate that post-therapy pathological tumor volume (ypTV) should be considered as an independent prognostic factor in advanced gastric cancer (GC) patients who underwent neoadjuvant chemotherapy (NAC) and gastrectomy. Due to the poor prognosis of patients with advanced gastric cancer (GC), neoadjuvant chemotherapy (NAC) has been used to improve survival [1]. There have been several NAC regimens that have been suggested by the National Comprehensive Cancer Network (NCCN) guidelines version 1.2017. This study was designed to assess the potential impact of tumor volume on long-term survival of patients treated with neoadjuvant chemotherapy and gastrectomy for cancer

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