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Determinants of clinical outcomes of gastric cancer patients treated with neoadjuvant chemotherapy: a sub-analysis of the PRODIGY study

 Hyung-Don Kim  ;  Jong Seok Lee  ;  Young Soo Park  ;  Jeong Hwan Yook  ;  Sung Hoon Noh  ;  Young-Kyu Park  ;  Young-Woo Kim  ;  Sang Cheul Oh  ;  Jong Gwang Kim  ;  Min-Hee Ryu  ;  Jae-Ho Cheong  ;  HyunKi Kim  ;  Joon Seok Lim  ;  Jae-Hyuk Lee  ;  Suk Hee Heo  ;  Jin Young Kim  ;  Mi Hwa Heo  ;  Young Iee Park  ;  In-Ho Kim  ;  Yoon-Koo Kang 
 GASTRIC CANCER, Vol.25(6) : 1039-1049, 2022-11 
Journal Title
Issue Date
Antineoplastic Combined Chemotherapy Protocols / therapeutic use ; Humans ; Middle Aged ; Neoadjuvant Therapy* ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* / drug therapy ; Stomach Neoplasms* / surgery ; Survival Rate
Clinical stage ; Gastric cancer ; Neoadjuvant chemotherapy ; Post-neoadjuvant chemotherapy pathological stage
Background: In this post hoc analysis of the PRODIGY study, we aimed to investigate factors associated with survival outcomes and provide evidence for designing optimal perioperative treatment strategies for gastric cancer patients receiving neoadjuvant chemotherapy.

Patients and methods: A total of 212 patients in the neoadjuvant chemotherapy group of the PRODIGY study were included as the study population. The prognostic impact of clinicopathologic factors, including the initial radiological clinical stage (cStage) and post-neoadjuvant chemotherapy pathological stage (ypStage), was analyzed.

Results: The median age was 58 years. The majority of patients (77.4%) had cStage III disease, and about 10% and 25% had ypStage 0 and I disease, respectively. According to the initial cStage, progression-free survival (PFS) and overall survival (OS) were significantly different (P < 0.01). PFS and OS were also different according to the ypStage (P < 0.01). In multivariate analyses, cStage IIIC disease (vs. cStage II) and ypStage II and III disease (vs. ypStage 0/I) were independent factors for poor survival outcomes. Based on the patterns of PFS and OS according to both cStage and ypStage, three patient groups were defined. These groups showed distinct PFS and OS (P < 0.01) with 5-year PFS rates of 95.7%, 77.9%, and 31.3% and 5-year OS rates of 95.7%, 82.4%, and 42.5%, respectively.

Conclusions: Both initial cStage and ypStage were independent factors for survival outcomes of gastric cancer patients treated with neoadjuvant chemotherapy. Efforts should be made to develop optimal peri-operative treatment strategies for patients at different risks according to cStage and ypStage.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
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