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Outcomes of Neoadjuvant Chemotherapy for Clinical Stages 2 and 3 Gastric Cancer Patients: Analysis of Timing and Site of Recurrence

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to analyze timing and sites of recurrence for patients receiving neoadjuvant chemotherapy for gastric cancer. Neoadjuvant chemotherapy followed by surgical resection is the standard treatment for locally advanced gastric cancer in the West, but limited information exists as to timing and patterns of recurrence in this setting.

Methods

Patients with clinical stage 2 or 3 gastric cancer treated with neoadjuvant chemotherapy followed by curative-intent resection between January 2000 and December 2015 were analyzed for 5-year recurrence-free survival (RFS) as well as timing and site of recurrence.

Results

Among 312 identified patients, 121 (38.8%) experienced recurrence during a median follow-up period of 46 months. The overall 5-year RFS rate was 58.9%, with RFS rates of 95.8% for ypT0N0, 81% for ypStage 1, 77.4% for ypStage 2, and 22.9% for ypStage 3. The first site of recurrence was peritoneal for 49.6%, distant (not peritoneal) for 45.5%, and locoregional for 11.6% of the patients. The majority of the recurrences (84.3%) occurred within 2 years. Multivariate analysis showed that ypT4 status was an independent predictor for recurrence within 1 year after surgery (odds ratio, 2.58; 95% confidence interval, 1.10–6.08; p = 0.030).

Conclusions

The majority of the recurrences for patients with clinical stage 2 or 3 gastric cancer who received neoadjuvant chemotherapy and underwent curative resection occurred within 2 years. After neoadjuvant chemotherapy, pathologic T stage was a useful risk predictor for early recurrence.

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Acknowledgments

This research was supported in part by the NIH/NCI Cancer Center Support Grant P30 CA008748. The authors acknowledge Jessica Moore, MS, staff editor at MSK, for editing the manuscript.

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Authors and Affiliations

  1. Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Masaya Nakauchi MD, Elvira Vos MD, PhD, Sam S. Yoon MD, Murray F. Brennan MD, Daniel G. Coit MD & Vivian E. Strong MD, FACS

  2. Gastrointestinal Pathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Laura H. Tang MD

  3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Mithat Gonen PhD

  4. Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Yelena Y. Janjigian MD, Geoffrey Y. Ku MD, David H. Ilson MD & Steven B. Maron MD

Authors
  1. Masaya Nakauchi MD
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  2. Elvira Vos MD, PhD
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  3. Laura H. Tang MD
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  4. Mithat Gonen PhD
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  5. Yelena Y. Janjigian MD
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  9. Sam S. Yoon MD
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  10. Murray F. Brennan MD
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  12. Vivian E. Strong MD, FACS
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Corresponding author

Correspondence to Vivian E. Strong MD, FACS.

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Disclosure

Dr. Yelena Y. Janjigian has received research funding provided to the institution from Rgenix, Boehringer Ingelheim, Bayer, Genentech/Roche, Bristol-Myers Squibb, Eli Lilly, and Merck, has served on advisory boards for Rgenix, Merck Serono, Bristol-Myers Squibb, Eli Lilly, Pfizer, Bayer, Imugene, Merck, Daiichi-Sankyo, and AstraZeneca. GYK, and has received honoraria and research funding from Merck, Bristol-Myers Squibb, and Pieris and research funding from AstraZeneca, Zymeworks, and Daiichi Sankyo. Dr. David H. Ilson has received research funding from and served on advisory boards for Astellas, Eli Lilly, Pieris, and Taiho, and has served on advisory boards for Astra-Zeneca, Amgen, Bayer, Bristol-Myers Squibb, and Roche. Dr. Steven B. Maron has received research funding from Genentech and travel expenses from Merck and Bayer. The remaining authors have no conflicts of interest.

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Nakauchi, M., Vos, E., Tang, L.H. et al. Outcomes of Neoadjuvant Chemotherapy for Clinical Stages 2 and 3 Gastric Cancer Patients: Analysis of Timing and Site of Recurrence. Ann Surg Oncol 28, 4829–4838 (2021). https://doi.org/10.1245/s10434-021-09624-5

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  • DOI: https://doi.org/10.1245/s10434-021-09624-5

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