Prognostic Impact of Post-operative Infectious Complications in Gastric Cancer Patients Receiving Neoadjuvant Chemotherapy: Post Hoc Analysis of a Randomized Controlled Trial, JCOG0501.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2024-09-01 Epub Date: 2024-05-04 DOI:10.1007/s12029-024-01061-3

Masato Hayashi, Takaki Yoshikawa, Junki Mizusawa, Shinji Hato, Yoshiaki Iwasaki, Mitsuru Sasako, Yasuyuki Kawachi, Hiroyasu Iishi, Yasuhiro Choda, Narikazu Boku, Masanori Terashima

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引用次数: 0

Abstract

Purpose: Post-operative infectious complication (IC) is a well-known negative prognostic factor, while showing neoadjuvant chemotherapy (NAC) may cancel out the negative influence of IC. This analysis compared the clinical impacts of IC according to the presence or absence of NAC in gastric cancer patients enrolled in the phase III clinical trial (JCOG0501) which compared upfront surgery (arm A) and NAC followed by surgery (arm B) in type 4 and large type 3 gastric cancer.

Methods: The subjects were 224 patients who underwent R0 resection out of 316 patients enrolled in JCOG0501. The prognoses of the patients with or without ICs in each arm were investigated by univariable and multivariable Cox regression analyses.

Results: There were 21 (20.0%) IC occurrences in arm A and 15 (12.6%) in arm B. In arm A, the overall survival (OS) of patients with ICs was slightly worse than those without IC (3-year OS, 57.1% in patients with ICs, 79.8% in those without ICs; adjusted hazard ratio (95% confidence interval), 1.292 (0.655-2.546)). In arm B, patients with ICs showed a trend of better survival than those without ICs (3-year OS, 80.0% in patients with IC, 74.0% in those without IC; adjusted hazard ratio, 0.573 (0.226-1.456)).

Conclusion: This study could not indicate the negative prognostic influence of ICs in gastric cancer patients receiving NAC, which might be canceled by NAC. To build exact evidence, further investigation with prospective and large numbers of data might be expected.

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接受新辅助化疗的胃癌患者术后感染并发症的预后影响：随机对照试验的事后分析》，JCOG0501.

目的：术后感染性并发症（IC）是众所周知的不良预后因素，而新辅助化疗（NAC）可消除IC的不良影响。本分析比较了在 III 期临床试验（JCOG0501）中，有无新辅助化疗对 4 型和大型 3 型胃癌患者的临床影响：研究对象是参加 JCOG0501 的 316 名患者中接受 R0 切除术的 224 名患者。通过单变量和多变量考克斯回归分析研究了各组有或无 IC 患者的预后：在 A 组中，有 IC 患者的总生存率（OS）略低于无 IC 患者（3 年 OS，有 IC 患者为 57.1%，无 IC 患者为 79.8%；调整后危险比（95% 置信区间）为 1.292（0.655-2.546））。在B组中，有IC的患者的生存率有高于无IC患者的趋势（3年OS，有IC患者为80.0%，无IC患者为74.0%；调整后危险比为0.573（0.226-1.456））：本研究无法说明IC对接受NAC治疗的胃癌患者的预后有负面影响，而NAC可能会抵消IC的影响。要建立确切的证据，可能需要进一步的前瞻性研究和大量数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.