{"title":"局部晚期胃癌患者新辅助治疗后的最佳反应人群:一项多中心研究。","authors":"Qing Zhong, Yuqin Sun, Mingqiao Lian, Zengbin Wang, Baolong Li, Junhua Yu, Yubin Ma, Shichao Wu, Yonghong Wang, Ju Wu, Jiyun Zhu, Wen Ye, Zhiquan Zhang, Caiming Weng, Dong Wu, Qiuxian Chen, Qiyue Chen, Ping Li, Chaohui Zheng, Lisheng Cai, Changming Huang","doi":"10.21147/j.issn.1000-9604.2025.02.05","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Pathologic complete response (pCR) following neoadjuvant therapy (NAT) for gastric cancer (GC) is rare but associated with a favorable prognosis. This study aims to reassess the optimal response population (ORP) following NAT by evaluating the prognostic outcomes associated with various T and N stages, utilizing multicenter data from China.</p><p><strong>Methods: </strong>Patients who underwent NAT following radical gastrectomy at 10 tertiary hospitals in China between 2008 and 2021 were included. The ORP was introduced to explore the disease-free survival (DFS), overall survival (OS), recurrence patterns, and influencing factors following propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 1,076 patients were enrolled in this study (median follow-up period: 60 months). We defined ORP as a pCR or tumor infiltration of the mucosal or submucosal layer without lymph node metastasis (pCR or ypT1N0) after NAT. The ORP group comprised 136 patients (12.6%), while the non-ORP group comprised 940 patients (87.4%). After applying a 1:4 PSM, we obtained an ORP group of 136 patients and non-ORP group of 544 patients. Survival analysis demonstrated that both the 3-year OS (before PSM: 89.0% <i>vs.</i> 55.0%, P<0.001; after PSM: 89.0% <i>vs.</i> 55.4%, P<0.001) and DFS (before PSM: 85.8% <i>vs.</i> 49.7%, P<0.001; after PSM: 85.8% <i>vs.</i> 50.6%, P<0.001) were significantly superior in the ORP group compared to that in the non-ORP group. Remarkably, adjuvant chemotherapy did not impact the prognosis of patients in the ORP group (3-year OS: 89.0% <i>vs.</i> 89.7%, P=0.988; 3-year DFS: 84.9% <i>vs.</i> 89.7%, P=0.700).</p><p><strong>Conclusions: </strong>This study reevaluates patients with ORP following NAT, providing a more comprehensive and accurate depiction of the potential beneficiary group and survival outcomes in patients with locally advanced GC.</p>","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"37 2","pages":"174-186"},"PeriodicalIF":7.0000,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062982/pdf/","citationCount":"0","resultStr":"{\"title\":\"Optimal response population after neoadjuvant therapy for patients with locally advanced gastric cancer: A multicenter study.\",\"authors\":\"Qing Zhong, Yuqin Sun, Mingqiao Lian, Zengbin Wang, Baolong Li, Junhua Yu, Yubin Ma, Shichao Wu, Yonghong Wang, Ju Wu, Jiyun Zhu, Wen Ye, Zhiquan Zhang, Caiming Weng, Dong Wu, Qiuxian Chen, Qiyue Chen, Ping Li, Chaohui Zheng, Lisheng Cai, Changming Huang\",\"doi\":\"10.21147/j.issn.1000-9604.2025.02.05\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Pathologic complete response (pCR) following neoadjuvant therapy (NAT) for gastric cancer (GC) is rare but associated with a favorable prognosis. This study aims to reassess the optimal response population (ORP) following NAT by evaluating the prognostic outcomes associated with various T and N stages, utilizing multicenter data from China.</p><p><strong>Methods: </strong>Patients who underwent NAT following radical gastrectomy at 10 tertiary hospitals in China between 2008 and 2021 were included. The ORP was introduced to explore the disease-free survival (DFS), overall survival (OS), recurrence patterns, and influencing factors following propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 1,076 patients were enrolled in this study (median follow-up period: 60 months). We defined ORP as a pCR or tumor infiltration of the mucosal or submucosal layer without lymph node metastasis (pCR or ypT1N0) after NAT. The ORP group comprised 136 patients (12.6%), while the non-ORP group comprised 940 patients (87.4%). After applying a 1:4 PSM, we obtained an ORP group of 136 patients and non-ORP group of 544 patients. Survival analysis demonstrated that both the 3-year OS (before PSM: 89.0% <i>vs.</i> 55.0%, P<0.001; after PSM: 89.0% <i>vs.</i> 55.4%, P<0.001) and DFS (before PSM: 85.8% <i>vs.</i> 49.7%, P<0.001; after PSM: 85.8% <i>vs.</i> 50.6%, P<0.001) were significantly superior in the ORP group compared to that in the non-ORP group. Remarkably, adjuvant chemotherapy did not impact the prognosis of patients in the ORP group (3-year OS: 89.0% <i>vs.</i> 89.7%, P=0.988; 3-year DFS: 84.9% <i>vs.</i> 89.7%, P=0.700).</p><p><strong>Conclusions: </strong>This study reevaluates patients with ORP following NAT, providing a more comprehensive and accurate depiction of the potential beneficiary group and survival outcomes in patients with locally advanced GC.</p>\",\"PeriodicalId\":9882,\"journal\":{\"name\":\"Chinese Journal of Cancer Research\",\"volume\":\"37 2\",\"pages\":\"174-186\"},\"PeriodicalIF\":7.0000,\"publicationDate\":\"2025-04-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062982/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Chinese Journal of Cancer Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21147/j.issn.1000-9604.2025.02.05\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chinese Journal of Cancer Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21147/j.issn.1000-9604.2025.02.05","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:胃癌新辅助治疗(NAT)后病理完全缓解(pCR)是罕见的,但与良好的预后相关。本研究旨在利用来自中国的多中心数据,通过评估与不同T和N阶段相关的预后结果,重新评估NAT后的最佳缓解人群(ORP)。方法:纳入2008年至2021年在中国10家三级医院根治性胃切除术后行NAT治疗的患者。引入ORP,探讨倾向评分匹配(PSM)后的无病生存期(DFS)、总生存期(OS)、复发模式及影响因素。结果:共纳入1076例患者(中位随访期:60个月)。我们将ORP定义为NAT后pCR或肿瘤浸润粘膜或粘膜下层,无淋巴结转移(pCR或ypT1N0)。ORP组136例(12.6%),非ORP组940例(87.4%)。采用1:4 PSM后,我们得到ORP组136例,非ORP组544例。生存分析显示,3年OS (PSM前:89.0% vs. 55.0%, PSM前:55.4%,PSM前:49.7%,PSM前:50.6%,PSM前:89.7%,P=0.988;3年DFS: 84.9% vs. 89.7%, P=0.700)。结论:本研究重新评估了NAT后ORP患者,为局部晚期GC患者的潜在受益群体和生存结果提供了更全面和准确的描述。
Optimal response population after neoadjuvant therapy for patients with locally advanced gastric cancer: A multicenter study.
Objective: Pathologic complete response (pCR) following neoadjuvant therapy (NAT) for gastric cancer (GC) is rare but associated with a favorable prognosis. This study aims to reassess the optimal response population (ORP) following NAT by evaluating the prognostic outcomes associated with various T and N stages, utilizing multicenter data from China.
Methods: Patients who underwent NAT following radical gastrectomy at 10 tertiary hospitals in China between 2008 and 2021 were included. The ORP was introduced to explore the disease-free survival (DFS), overall survival (OS), recurrence patterns, and influencing factors following propensity score matching (PSM).
Results: A total of 1,076 patients were enrolled in this study (median follow-up period: 60 months). We defined ORP as a pCR or tumor infiltration of the mucosal or submucosal layer without lymph node metastasis (pCR or ypT1N0) after NAT. The ORP group comprised 136 patients (12.6%), while the non-ORP group comprised 940 patients (87.4%). After applying a 1:4 PSM, we obtained an ORP group of 136 patients and non-ORP group of 544 patients. Survival analysis demonstrated that both the 3-year OS (before PSM: 89.0% vs. 55.0%, P<0.001; after PSM: 89.0% vs. 55.4%, P<0.001) and DFS (before PSM: 85.8% vs. 49.7%, P<0.001; after PSM: 85.8% vs. 50.6%, P<0.001) were significantly superior in the ORP group compared to that in the non-ORP group. Remarkably, adjuvant chemotherapy did not impact the prognosis of patients in the ORP group (3-year OS: 89.0% vs. 89.7%, P=0.988; 3-year DFS: 84.9% vs. 89.7%, P=0.700).
Conclusions: This study reevaluates patients with ORP following NAT, providing a more comprehensive and accurate depiction of the potential beneficiary group and survival outcomes in patients with locally advanced GC.
期刊介绍:
Chinese Journal of Cancer Research (CJCR; Print ISSN: 1000-9604; Online ISSN:1993-0631) is published by AME Publishing Company in association with Chinese Anti-Cancer Association.It was launched in March 1995 as a quarterly publication and is now published bi-monthly since February 2013.
CJCR is published bi-monthly in English, and is an international journal devoted to the life sciences and medical sciences. It publishes peer-reviewed original articles of basic investigations and clinical observations, reviews and brief communications providing a forum for the recent experimental and clinical advances in cancer research. This journal is indexed in Science Citation Index Expanded (SCIE), PubMed/PubMed Central (PMC), Scopus, SciSearch, Chemistry Abstracts (CA), the Excerpta Medica/EMBASE, Chinainfo, CNKI, CSCI, etc.