Conditional Survival Rate of Patients Undergoing Gastrectomy with D2 Lymph Node Dissection After Neoadjuvant...

Area of Science:

• Oncology
• Surgical Oncology
• Chemotherapy

Background:

• Conditional survival rates offer a dynamic estimation of patient prognosis that evolves over time.
• Gastric cancer management often involves neoadjuvant chemotherapy followed by radical gastrectomy.
• Assessing conditional survival is crucial for refining prognostic predictions in gastric cancer patients.

Purpose of the Study:

• To evaluate the conditional disease-specific survival rate (CDS) and conditional recurrence-free survival rate (CRFS) in gastric cancer patients.
• To analyze survival trends in patients undergoing gastrectomy after neoadjuvant chemotherapy.
• To identify prognostic factors influencing survival outcomes in this patient cohort.

Main Methods:

• The study included 260 patients who underwent gastrectomy with D2 lymph node dissection post-neoadjuvant chemotherapy.
• Conditional survival rates (2-year CDS2 and CRFS2) were calculated using established formulas based on actuarial survival data.
• Cox proportional risk regression analysis was employed to determine factors associated with disease-specific survival (DSS) and recurrence-free survival (RFS).

Main Results:

• Actuarial 1-, 3-, and 5-year DSS rates were 82%, 57.6%, and 50.7%, respectively.
• Conditional 2-year DSS rates (CDS2) after 1, 3, and 5 years of survival were 70.2%, 88%, and 93.3%, respectively.
• Actuarial 1-, 3-, and 5-year RFS rates were 73.1%, 52.5%, and 46.4%, respectively, with corresponding CDS2 rates of 71.8%, 88.4%, and 100%.

Conclusions:

• Conditional survival rates (CDS and CRFS) for gastric cancer patients increase progressively over time post-treatment.
• Patients with unfavorable tumor characteristics demonstrated the most significant improvements in both conditional survival metrics.
• These findings underscore the dynamic nature of prognosis and the potential benefits of neoadjuvant chemotherapy in improving long-term survival for gastric cancer patients.