Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trial
Abstract Background Perioperative chemotherapy combined with D2 radical gastrectomy has been proven to be the standard treatment for local advanced gastric cancer. However, tumor regression grading (TRG) is the only neoadjuvant chemotherapy (NACT) response evaluation criterion recommended by the NCC...
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2025-03-01
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| Online Access: | https://doi.org/10.1186/s12885-024-13372-6 |
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| author | Xuejun Gan Yongning Jia Fei Shan Xiangji Ying Shuangxi Li Yan Zhang Fei Pang Ziyu Li |
| author_facet | Xuejun Gan Yongning Jia Fei Shan Xiangji Ying Shuangxi Li Yan Zhang Fei Pang Ziyu Li |
| author_sort | Xuejun Gan |
| collection | DOAJ |
| description | Abstract Background Perioperative chemotherapy combined with D2 radical gastrectomy has been proven to be the standard treatment for local advanced gastric cancer. However, tumor regression grading (TRG) is the only neoadjuvant chemotherapy (NACT) response evaluation criterion recommended by the NCCN guideline for gastric cancer (GC). Given TRG’s limitations, we aim to explore a better comprehensive response evaluation method in this study. Methods Clinical information of 96 GC patients who received NACT was collected prospectively. Clinicopathological variables predictive of the response to NACT were identified by comparing the pre- and post-NACT examination results. The correlations between the response mode and long-term survival rate were assessed. Results Univariate Cox regression analysis showed that CT-based evaluation of the primary lesion thickness (CT-thickness) and tumor markers (TMs) were significantly associated with prognosis. The comprehensive evaluation method, including CT-thickness, TRG, and TMs, was constructed and proved to have a higher Harrell’s C index. Significant differences in overall survival (OS) and recurrence-free survival (RFS) were observed between responders and non-responders distinguished by the comprehensive evaluation method. Conclusions The combination of CT-thickness, TRG, and TMs could be used to construct a pragmatic NACT efficacy evaluation method with both high sensitivity and specificity, which could facilitate clinical decision-making, NACT-related clinical research conduction, and efficacy predictive biomarker exploration. |
| format | Article |
| id | doaj-art-e2c3a0bab4874957b528f3f5772a2dc2 |
| institution | OA Journals |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-e2c3a0bab4874957b528f3f5772a2dc22025-08-20T01:57:45ZengBMCBMC Cancer1471-24072025-03-0125111310.1186/s12885-024-13372-6Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trialXuejun Gan0Yongning Jia1Fei Shan2Xiangji Ying3Shuangxi Li4Yan Zhang5Fei Pang6Ziyu Li7Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), gastrointestinal surgery of department, Peking University Cancer Hospital & Institute State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, gastrointestinal surgery of department, Peking University Cancer Hospital & Institute State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, gastrointestinal surgery of department, Peking University Cancer Hospital & InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), gastrointestinal surgery of department, Peking University Cancer Hospital & InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), gastrointestinal surgery of department, Peking University Cancer Hospital & InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), gastrointestinal surgery of department, Peking University Cancer Hospital & InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), gastrointestinal surgery of department, Peking University Cancer Hospital & InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), gastrointestinal surgery of department, Peking University Cancer Hospital & InstituteAbstract Background Perioperative chemotherapy combined with D2 radical gastrectomy has been proven to be the standard treatment for local advanced gastric cancer. However, tumor regression grading (TRG) is the only neoadjuvant chemotherapy (NACT) response evaluation criterion recommended by the NCCN guideline for gastric cancer (GC). Given TRG’s limitations, we aim to explore a better comprehensive response evaluation method in this study. Methods Clinical information of 96 GC patients who received NACT was collected prospectively. Clinicopathological variables predictive of the response to NACT were identified by comparing the pre- and post-NACT examination results. The correlations between the response mode and long-term survival rate were assessed. Results Univariate Cox regression analysis showed that CT-based evaluation of the primary lesion thickness (CT-thickness) and tumor markers (TMs) were significantly associated with prognosis. The comprehensive evaluation method, including CT-thickness, TRG, and TMs, was constructed and proved to have a higher Harrell’s C index. Significant differences in overall survival (OS) and recurrence-free survival (RFS) were observed between responders and non-responders distinguished by the comprehensive evaluation method. Conclusions The combination of CT-thickness, TRG, and TMs could be used to construct a pragmatic NACT efficacy evaluation method with both high sensitivity and specificity, which could facilitate clinical decision-making, NACT-related clinical research conduction, and efficacy predictive biomarker exploration.https://doi.org/10.1186/s12885-024-13372-6Gastric cancerNeoadjuvant chemotherapy (NACT)Tumor regression grading (TRG)Tumor marker (TM)Response evaluation |
| spellingShingle | Xuejun Gan Yongning Jia Fei Shan Xiangji Ying Shuangxi Li Yan Zhang Fei Pang Ziyu Li Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trial BMC Cancer Gastric cancer Neoadjuvant chemotherapy (NACT) Tumor regression grading (TRG) Tumor marker (TM) Response evaluation |
| title | Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trial |
| title_full | Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trial |
| title_fullStr | Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trial |
| title_full_unstemmed | Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trial |
| title_short | Comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer - a post hoc analysis of a single-center randomized controlled trial |
| title_sort | comprehensive evaluation of tumor response better evaluates the efficacy of neoadjuvant chemotherapy and predicts the prognosis in gastric cancer a post hoc analysis of a single center randomized controlled trial |
| topic | Gastric cancer Neoadjuvant chemotherapy (NACT) Tumor regression grading (TRG) Tumor marker (TM) Response evaluation |
| url | https://doi.org/10.1186/s12885-024-13372-6 |
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