{"title":"残留淋巴结转移预测胃癌术前化疗及手术后复发的临床意义。","authors":"Keisuke Komori, Takanobu Yamada, Shuji Ando, Shinsuke Nagasawa, Kyohei Kanematsu, Junya Morita, Mie Tanabe, Yuta Nakayama, Yasushi Rino, Aya Saito, Takashi Ogata, Takashi Oshima","doi":"10.21873/anticanres.17507","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>Neoadjuvant chemotherapy is gaining recognition for its potential to improve survival outcomes, with combined neoadjuvant and adjuvant therapies under investigation. However, the prognostic significance of post-chemotherapy pathological staging (ypStage) on recurrence-free survival (RFS) remains unclear. This study aimed to evaluate the utility of ypStage, ypT, ypN classification, and histological response rate in predicting recurrence after gastrectomy.</p><p><strong>Patients and methods: </strong>This retrospective study included 125 patients who underwent radical gastrectomy after preoperative chemotherapy at the Kanagawa Cancer Center between January 2007 and November 2019. RFS was analyzed based on ypStage, ypT, ypN classification, and histological response rate, with prognostic factors also assessed.</p><p><strong>Results: </strong>The 5-year RFS rates were 81.6% for ypStage I, 49.0% for ypStage II, and 42.9% for ypStage III. Significant differences were observed between ypStage I and ypStage II (<i>p</i>=0.025) but not between ypStage II and ypStage III (<i>p</i> =0.633). In ypStage II/III cases, the 5-year RFS rate was significantly higher for ypN0/1/2 (55.4%) compared to ypN3 (21.5%) (<i>p</i>=0.003). ypN was selected as an independent predictor for relapse in multivariate analysis.</p><p><strong>Conclusion: </strong>ypStage effectively predicts recurrence in ypStage I cases after preoperative chemotherapy and surgery for gastric cancer. However, prognosis in patients with ypStage II/III is better stratified using the ypN classification, particularly ypN3.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":"45 3","pages":"1205-1214"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Significance of Residual Lymph Node Metastasis in Predicting Recurrence After Preoperative Chemotherapy and Surgery for Gastric Cancer.\",\"authors\":\"Keisuke Komori, Takanobu Yamada, Shuji Ando, Shinsuke Nagasawa, Kyohei Kanematsu, Junya Morita, Mie Tanabe, Yuta Nakayama, Yasushi Rino, Aya Saito, Takashi Ogata, Takashi Oshima\",\"doi\":\"10.21873/anticanres.17507\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>Neoadjuvant chemotherapy is gaining recognition for its potential to improve survival outcomes, with combined neoadjuvant and adjuvant therapies under investigation. However, the prognostic significance of post-chemotherapy pathological staging (ypStage) on recurrence-free survival (RFS) remains unclear. This study aimed to evaluate the utility of ypStage, ypT, ypN classification, and histological response rate in predicting recurrence after gastrectomy.</p><p><strong>Patients and methods: </strong>This retrospective study included 125 patients who underwent radical gastrectomy after preoperative chemotherapy at the Kanagawa Cancer Center between January 2007 and November 2019. RFS was analyzed based on ypStage, ypT, ypN classification, and histological response rate, with prognostic factors also assessed.</p><p><strong>Results: </strong>The 5-year RFS rates were 81.6% for ypStage I, 49.0% for ypStage II, and 42.9% for ypStage III. Significant differences were observed between ypStage I and ypStage II (<i>p</i>=0.025) but not between ypStage II and ypStage III (<i>p</i> =0.633). In ypStage II/III cases, the 5-year RFS rate was significantly higher for ypN0/1/2 (55.4%) compared to ypN3 (21.5%) (<i>p</i>=0.003). ypN was selected as an independent predictor for relapse in multivariate analysis.</p><p><strong>Conclusion: </strong>ypStage effectively predicts recurrence in ypStage I cases after preoperative chemotherapy and surgery for gastric cancer. However, prognosis in patients with ypStage II/III is better stratified using the ypN classification, particularly ypN3.</p>\",\"PeriodicalId\":8072,\"journal\":{\"name\":\"Anticancer research\",\"volume\":\"45 3\",\"pages\":\"1205-1214\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anticancer research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21873/anticanres.17507\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anticancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/anticanres.17507","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Clinical Significance of Residual Lymph Node Metastasis in Predicting Recurrence After Preoperative Chemotherapy and Surgery for Gastric Cancer.
Background/aim: Neoadjuvant chemotherapy is gaining recognition for its potential to improve survival outcomes, with combined neoadjuvant and adjuvant therapies under investigation. However, the prognostic significance of post-chemotherapy pathological staging (ypStage) on recurrence-free survival (RFS) remains unclear. This study aimed to evaluate the utility of ypStage, ypT, ypN classification, and histological response rate in predicting recurrence after gastrectomy.
Patients and methods: This retrospective study included 125 patients who underwent radical gastrectomy after preoperative chemotherapy at the Kanagawa Cancer Center between January 2007 and November 2019. RFS was analyzed based on ypStage, ypT, ypN classification, and histological response rate, with prognostic factors also assessed.
Results: The 5-year RFS rates were 81.6% for ypStage I, 49.0% for ypStage II, and 42.9% for ypStage III. Significant differences were observed between ypStage I and ypStage II (p=0.025) but not between ypStage II and ypStage III (p =0.633). In ypStage II/III cases, the 5-year RFS rate was significantly higher for ypN0/1/2 (55.4%) compared to ypN3 (21.5%) (p=0.003). ypN was selected as an independent predictor for relapse in multivariate analysis.
Conclusion: ypStage effectively predicts recurrence in ypStage I cases after preoperative chemotherapy and surgery for gastric cancer. However, prognosis in patients with ypStage II/III is better stratified using the ypN classification, particularly ypN3.
期刊介绍：
ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed.
ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies).
Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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