Progrnosis value of CT histopathological regression in advanced gastric cancer after neoadjuvant chemotherapy
LIU Yong
ZHENG Zhichao
ZHAO Yan
ZHANG Jianjun
ZHANG Tao
ZHU Haitao
LIU Yanqing
Abstract：Objective To investigate the CT regression degree and pathological reaction, and their relationship with survival rate after neoadjuvant chemotherapy for advanced gastric cancer.Methods One hundred and twenty patients with ad-vanced gastric carcinoma were enrolled, they were divided into chemotherapy +operation group and routine operation group, chemotherapy +operation group received FOLFOX-7 regimen chemotherapy for 2 cycles, then standard gastric cancer radical operation was performed, routine operation group underwent standard radical resection of gastric cancer.Observing the clinical regression degree, adverse reactions of chemotherapy, CT regression degree, pathological reaction degree in the chemotherapy plus operation group.Compare the R0 resection rate and survival differences between the 2 groups.Evaluate the relationship between CT relieve degree and pathological reaction degree, and the relationship between them and the survival period.Results The adverse reaction of chemotherapy combined with operation group were nausea and vomiting, without the level III, IV adverse reaction.Chemotherapy plus surgery group’ s CT relieve rate was 60.0%;the tumor control rate was 90.0%.20 ca-ses showed clinical down-staging, down-staging rate reached 33.3%.Pathological response revealed that effective group of 11 cases (18.3%), invalid group of 49 cases (81.7%).CT relieve degree was negative correlated with the pathological reac-tion degree ( r =-0.391, P =0.002).Chemotherapy plus surgery group’ s R0 resection rate was 86.6%, the surgery group’s R0 resection rate was 78.3%, which showed significant difference ( P =0.022).No differences of the survival curve between the 2 groups, but stratified analysis of stage IIIc patients’ survival period showed that chemotherapy +surgery group’s survival period were higher than that of the surgery group, there was significant different ( P =0.042).CT relieve group and no relieve group had a statistically significant differences of the survival period ( P =0.035), but the pathological effective group and ineffective group’s survival period did not reveal statistical significance different ( P =0.816).Conclu-sion The preoperative chemotherapy can improve the R0 resection rate in patients with progressive stage gastric cancer, in-fluence the stage IIIc patient’s survival period, and is safe and reliable.CT regression degree can be used as a reference in-dex for judging the degree of effective chemotherapy and prognosis.
Keywords：Neoadjuvant chemotherapyAdvanced gastric cancerPathological response classification
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 596-599,603 )