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Borrmann Type Predicts Response to Preoperative Therapy in Advanced Gastric Cancer

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Abstract

Purpose

The Borrmann classification system is widely used to classify advanced gastric cancer (GC). No studies have focused on the relationship between Borrmann type and response to preoperative therapy.

Methods

Patients with advanced GC who received preoperative therapy followed by curative-intent gastrectomy from September 2016 through September 2021 were identified. Clinicopathologic characteristics were compared by Borrmann type. Logistic regression models were fit to analyze the relationship between Borrmann type and pCR rate.

Results

Of the 227 patients who underwent gastrectomy during the period studied, 73 had pretreatment endoscopic images available for analysis. We classified the tumors as follows: Borrmann type 1, 4 (6%); type 2, 17 (23%); type 3, 33 (45%); and type 4, 19 (26%). Nine patients (12%) achieved pCR; 6 of these (67%) had type 1/2 GC and 3 (33%) had type 3. Multivariable logistic regression showed that Borrmann type 3/4 was the only independent factor associated with pCR (odds ratio 0.12; p = 0.023), but 2-year overall survival rates did not differ by Borrmann type (p = 0.216).

Conclusion

Patients with Borrmann type 3/4 advanced GC have a lower likelihood of achieving pCR after preoperative therapy than those with type 1/2 GC. Determining the Borrmann type preoperatively can guide treatment decision-making.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank Erica Goodoff, Senior Scientific Editor in the Research Medical Library at The University of Texas MD Anderson Cancer Center, for editing this article.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX, USA

    Yuki Hirata, Annamaria Agnes, Laura R. Prakash, Paul Mansfield, Brian D. Badgwell & Naruhiko Ikoma

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  1. Yuki Hirata
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  2. Annamaria Agnes
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  3. Laura R. Prakash
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  4. Paul Mansfield
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  5. Brian D. Badgwell
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  6. Naruhiko Ikoma
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Yuki Hirata, Annamaria Agnes, Laura Prakash, and Naruhiko Ikoma. The first draft of the manuscript was written by Yuki Hirata and Naruhiko Ikoma, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Naruhiko Ikoma.

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Ethics Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and regional) and with the Helsinki Declaration of 1975, as revised in 1983. Because this was a retrospective study of de-identified patients, no informed consent was required. Ethics approval for this work was obtained.

Competing Interests

Naruhiko Ikoma received a research grant from Intuitive Surgical. All other authors declare no competing interests.

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Hirata, Y., Agnes, A., Prakash, L.R. et al. Borrmann Type Predicts Response to Preoperative Therapy in Advanced Gastric Cancer. J Gastrointest Canc 54, 882–889 (2023). https://doi.org/10.1007/s12029-022-00880-6

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