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Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: New perspectives from a single‐center experience
Author(s) -
Lombardi Pietro Maria,
Mazzola Michele,
Achilli Pietro,
Aquilano Maria Costanza,
De Martini Paolo,
Curaba Annabella,
Gualtierotti Monica,
Bertoglio Camillo L.,
Magistro Carmelo,
Ferrari Giovanni
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26391
Subject(s) - medicine , grading (engineering) , univariate analysis , lymph node , multivariate analysis , single center , chemotherapy , perioperative , neoadjuvant therapy , oncology , pathological , gastroenterology , cancer , stage (stratigraphy) , surgery , paleontology , civil engineering , breast cancer , engineering , biology
Background and Objective Perioperative 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. Methods Patients 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. Results One‐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. Conclusions TRG, LNR, and tumor size are independent prognostic factors for DFS and DSS in patients with advanced GC undergoing NACT.