Neoadjuvant Therapies for Patients with Locally Advanced Gastric Cancer: A Retrospective Cohort Study

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Gastric cancer is a leading cause of cancer mortality, often diagnosed at advanced stages.
• Early symptoms are typically absent, complicating timely diagnosis and treatment.
• While surgery offers curative potential, neoadjuvant chemotherapy (NACT) is crucial for improving prognosis in locally advanced gastric cancer (LAGC).

Purpose of the Study:

• To evaluate the impact of neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy (NACT+S+AC) versus surgery followed by adjuvant chemotherapy (S+AC) on survival and outcomes in LAGC patients.
• To compare clinicopathological characteristics and postoperative outcomes between the two treatment groups.

Main Methods:

• Retrospective analysis of locally advanced gastric cancer patients who underwent surgery between 2015-2022.
• Patients were divided into two groups: Group 1 (NACT+S+AC) and Group 2 (S+AC).
• Comparison of clinicopathological features, postoperative complications, recurrence, metastasis, overall survival (OS), and disease-free survival (DFS).

Main Results:

• Group 1 included 84 patients; Group 2 included 60 patients.
• Group 2 showed significantly higher rates of perineural/lymphovascular invasion and metastatic lymph nodes (P < .05).
• Group 1 had lower postoperative complication rates (22.6% vs 33.33%, P = .034), and significantly longer OS and DFS (P < .05).

Conclusions:

• Neoadjuvant chemotherapy significantly enhances survival in LAGC patients.
• NACT reduces recurrence, metastasis, and postoperative complications.
• Key survival factors include NACT administration, metastatic lymph node count, and lymphovascular invasion.