Abstract
In this retrospective study, we analyzed prognostic factors associated with survival outcomes in 73 locally advanced gastric cancer patients treated with neoadjuvant chemotherapy (NAC) followed by surgical resection. Median disease-free survival (DFS) for 64 patients that received R0 resection was 685 days, whereas median overall survival (OS) for 73 patients was 930 days. Multivariate analysis demonstrated that post-treatment nodal stages (P = 0.002), nervous invasion (P = 0.0492) and serum CA199 levels (P = 0.0398) were independent prognostic factors for DFS. Nodal stages (P = 0.0007), presence of nervous invasion (P = 0.0259) and non-radical resection (P = 0.0165) were independent prognostic factors for OS. These results indicate that post-treatment nodal stages, neural invasion and serum CA199 levels are all associated with poor DFS. Moreover, post-treatment nodal stage, resection type and neural invasion status are independent prognostic factors for OS.
Highlights
Gastric cancer ranks fifth among most malignant cancers and third among cancer related deaths worldwide [1]
Patients with potentially resectable gastric cancer are treated with neoadjuvant chemotherapy to improve survival
Followed by surgery, age at diagnosis, post-treatment nodal status, diffuse-type histology, perineural invasion/vascular invasion and salvage surgery are associated with overall survival (OS) [10
Summary
Gastric cancer ranks fifth among most malignant cancers and third among cancer related deaths worldwide [1]. China has the highest incidence of gastric cancer accounting for 35% of total gastric cancer cases worldwide with a high mortality rate of 25.16 cases per. Prognosis of locally advanced gastric cancer is poor with a 5-year overall survival (OS) rate of20-30%. For surgery-only patients [3]. Neoadjuvant chemotherapy (NAC) is preferred for locally advanced gastric cancer patients since the release of the MRC Adjuvant Gastric. Many studies demonstrate that NAC reduces the size of gastric cancer lesions thereby decreasing tumor staging and increasing the chances for radical resection and survival while decreasing post-operative complications [5,6,7,8,9]. Standard regimen and courses of NAC are not yet established and prognostic factors associated with survival outcomes for patients treated with NAC followed by surgery remain unclear
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