Title Histologic lymph nodes regression after preoperative chemotherapy as prognostic factor in non-metastatic advanced gastric adenocarcinoma /
Authors Baušys, Augustinas ; Senina, Veslava ; Lukšta, Martynas ; Anglickienė, Giedrė ; Molnikaitė, Greta ; Baušys, Bernardas ; Rybakovas, Andrius ; Baltruškevičienė, Edita ; Laurinavičius, Arvydas ; Poškus, Tomas ; Baušys, Rimantas ; Šeinin, Dmitrij ; Strupas, Kęstutis
DOI 10.7150/jca.49673
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Is Part of Journal of cancer.. Lake Haven : Ivyspring International Publisher. 2021, vol. 12, no. 6, p. 1669-1677.. ISSN 1837-9664
Keywords [eng] gastric cancer ; preoperative chemotherapy ; histological regression ; nodal regression
Abstract [eng] Background: The study aims to evaluate the lymph node (LN) response to preoperative chemotherapy and its impact on long-term outcomes in advanced gastric cancer (AGC). Methods: Histological specimens retrieved at gastrectomy from patients who received preoperative chemotherapy were evaluated. LN regression was graded by the adapted tumor regression grading system proposed by Becker. Patients were classified as node-negative (lnNEG) in the case of all negative LN without evidence of previous tumor involvement. Patients with LN metastasis were classified as nodal responders (lnR) in case of a regression score 1a-2 was detected in the LN. Nodal non-responders (lnNR) had a regression score of 3 in all of the metastatic nodes. Survival was compared using Kaplan-Meier and Cox regression analysis. Results: Among 87 patients included in the final analysis 29.9 % were lnNEG, 21.8 % were lnR and 48.3 % were lnNR. Kaplan-Meier curves showed a survival benefit for lnR over lnNR (p=0.03), while the survival of lnR and lnNEG patients was similar. Cox regression confirmed nodal response to be associated with decreased odds for death in univariate (HR: 0.33; 95 % CI 0.11-0.96, p=0.04) and multivariable (HR 0.37; 95 CI% 0.14-0.99, p=0.04) analysis. Conclusions: Histologic regression of LN metastasis after preoperative chemotherapy predicts the increased survival of patients with non-metastatic resectable AGC.
Published Lake Haven : Ivyspring International Publisher
Type Journal article
Language English
Publication date 2021
CC license CC license description