Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: New perspectives from a single‐center experience

Journal of Surgical Oncology - Tập 123 Số 4 - Trang 923-931 - 2021
Pietro Maria Lombardi1, Michele Mazzola1, Pietro Achilli1, Maria Costanza Aquilano2, Paolo De Martini1, Annabella Curaba3, Monica Gualtierotti1, Camillo Leonardo Bertoglio1, Carmelo Magistro1, Giovanni Ferrari1
1Division of Minimally-invasive Surgical Oncology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, Milan, Italy
2Department of Oncology and Hemat-Oncology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, Milan, Italy
3Department of Pathology and Cytogenetics, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, Milan, Italy

Tóm tắt

AbstractBackground and ObjectivePerioperative chemotherapy (PC) with radical surgery represents the gold standard of treatment for resectable advanced gastric cancer (GC). The prognostic value of pathological tumor regression grade (TRG) induced by neoadjuvant chemotherapy (NACT) is not clearly established. This study aimed to investigate the correlation between TRG and survival in GC.MethodsPatients affected by advanced GC undergoing PC and radical surgery were considered. TRG was assessed for each patient according to Becker's grading system. The correlation between TRG and survival was investigated.ResultsOne‐hundred patients were selected; 25 showed a good response (GR) (TRG 1a/1b), while 75 had a poor response (PR) (TRG 2/3) to NACT. GR patients showed better disease‐free survival (DFS) (52 vs. 19 months, p < .001) and disease‐specific survival (DSS) (57 vs. 25 months, p < .0001) when compared to PR patients. On univariate analysis, TRG, lymph node ratio (LNR), tumor size, grading, and post‐neoadjuvant therapy TNM stage were significantly correlated with survival. On multivariate analysis, TRG, LNR and tumor size were independent prognostic factors for DFS and DSS.ConclusionsTRG, LNR, and tumor size are independent prognostic factors for DFS and DSS in patients with advanced GC undergoing NACT.

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Journal of Surgical Oncology

Tập 123 Số 4

923-931

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