Abstract:
Objective To investigate the baseline characteristics of pathological complete response (pCR) after neoadjuvant therapy for locally advanced gastric cancer.
Methods From June 2011 to March 2018, 452 patients with locally advanced gastric cancer (cT3/4N0/+M0) admitted to the Fourth Hospital of Hebei Medical University were retrospectively analyzed, and the clinical factors related to pCR were studied using Logistic univariate and multivariate regression analyses.
Results All 452 patients completed neoadjuvant therapy and underwent radical surgery, and 44 (9.7%) of them achieved pCR. T3 stage before neoadjuvant therapy, a maximum tumor diameter < 4 cm, a carbohydrate antigen 19-9 (CA199) level ≤ 30 U/mL before treatment, end of treatment with an operative interval of ≥ 6 weeks, concurrent chemoradiotherapy, and the use of a combined targeted therapy regimen were associated with a high pCR rate after neoadjuvant therapy for locally advanced gastric cancer. T3 stage, CA199 levels ≤ 30 U/mL, a maximum tumor diameter < 4 cm, concurrent chemoradiotherapy, and the use of combined targeted therapy before treatment were independent factors influencing the occurrence of pCR after neoadjuvant therapy for advanced gastric cancer. Each of these parameters was assigned 1 point. The probability of pCR was 34.48% among patients with a score >2 and 6.09% among patients with a score ≤ 2.
Conclusions The pretreatment clinical stage, CA199 level, tumor size, and treatment pattern influence the occurrence of pCR after neoadjuvant therapy, and the incidence can be effectively identified by a predictive scoring model.