Posttherapy topographical nodal status, ypN-site, predicts survival of patients who received neoadjuvant chemotherapy followed by curative surgical resection for non-type 4 locally advanced gastric cancer: supplementary analysis of JCOG1004-A
Background Perioperative treatment is an accepted standard approach for treating locally advanced gastric cancer (LAGC). Histopathological tumor regression with
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| Veröffentlicht in: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2021, Vol.24 (1), p.197-204 |
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| creator | Fujitani, Kazumasa Nakamura, Kenichi Mizusawa, Jyunki Kuwata, Takeshi Shimoda, Tadakazu Katayama, Hiroshi Kushima, Ryoji Taniguchi, Hirokazu Yoshikawa, Takaki Boku, Narikazu Terashima, Masanori Fukuda, Haruhiko Sano, Takeshi Sasako, Mitsuru |
| description | Background
Perioperative treatment is an accepted standard approach for treating locally advanced gastric cancer (LAGC). Histopathological tumor regression with |
| doi_str_mv | 10.1007/s10120-020-01098-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2416273489</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2476157259</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-c64c3f70bb321b0121fa4230d5adc8aa83ee80a398384738996f37350439944f3</originalsourceid><addsrcrecordid>eNp9kktv1DAQxyMEog_4AhyQJS49NOBXXtyqFS2ginKAc-Q4k12vnDjYTlb52nwCJmwXJA4cbI_t3_xnPJ4kecXoW0Zp8S4wyjhN6ToYrcr08CQ5Z1LkqRA0e3qyecXOkosQ9pSyrGL58-RM8KzgRcXPk59fXYhxB16NC4ludFu0dkYrSwbX4hyiilO4Jsv4JQ0mwjUZPbRGx0DC5GczI-M6MqpoYMDDw84RDxrMDC0ZwKl2P81qiETvoHenSJ2z1h2QaBaiJ4_OM6x629-RPQTQ0bgBOY95DGlcRiCSWIfXdiGqRUmN7lsVojea6HXr36PEOFroMRPlERuUXYIJa4KfNw93WDWZ3rxInnXKBnj5uF4m328_fNt8TO8f7j5tbu5TLQsaU51LLbqCNo3grMFKs05JLmibqVaXSpUCoKRKVKUoZSHKqso7UYiMSlFVUnbiMrk66o7e_ZggxLo3QYO1CssyhZpLlvNCyLJC9M0_6N5NHrNfqSJn-FvZSvEjpb0LwUNXj970-NCa0XrtiPrYETVdx9oR9QGdXj9KT00P7R-XUwsgII5AwKthC_5v7P_I_gKjHMbd</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2476157259</pqid></control><display><type>article</type><title>Posttherapy topographical nodal status, ypN-site, predicts survival of patients who received neoadjuvant chemotherapy followed by curative surgical resection for non-type 4 locally advanced gastric cancer: supplementary analysis of JCOG1004-A</title><source>EZB-FREE-00999 freely available EZB journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Fujitani, Kazumasa ; Nakamura, Kenichi ; Mizusawa, Jyunki ; Kuwata, Takeshi ; Shimoda, Tadakazu ; Katayama, Hiroshi ; Kushima, Ryoji ; Taniguchi, Hirokazu ; Yoshikawa, Takaki ; Boku, Narikazu ; Terashima, Masanori ; Fukuda, Haruhiko ; Sano, Takeshi ; Sasako, Mitsuru</creator><creatorcontrib>Fujitani, Kazumasa ; Nakamura, Kenichi ; Mizusawa, Jyunki ; Kuwata, Takeshi ; Shimoda, Tadakazu ; Katayama, Hiroshi ; Kushima, Ryoji ; Taniguchi, Hirokazu ; Yoshikawa, Takaki ; Boku, Narikazu ; Terashima, Masanori ; Fukuda, Haruhiko ; Sano, Takeshi ; Sasako, Mitsuru ; Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan ; the Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan</creatorcontrib><description>Background
Perioperative treatment is an accepted standard approach for treating locally advanced gastric cancer (LAGC). Histopathological tumor regression with < 10% residual tumor is a globally accepted prognosticator in LAGC patients who received neoadjuvant chemotherapy (NAC) and curative surgery. However, despite a response of the primary tumor, a significant percentage of patients dies from recurrence and identification of those at risk for relapse remains challenging. We re-estimated the value of histopathological tumor regression as a prognosticator alongside other factors, especially posttherapy topographical nodal status, ypN-site.
Patients and methods
Individual patient data including clinicopathological variables were used from the four JCOG trials investigating NAC (JCOG0001, JCOG0002, JCOG0210, JCOG0405) for analyzing prognosticators in patients with curative surgery excluding those with type 4 AGC by univariable and multivariable Cox regression analyses.
Results
Among 85 patients, 5-year overall survival (OS) was 46.0% [95% confidence interval (CI) 35.0–56.4] with a median follow-up of 3.2 years. On univariable analysis, histopathological tumor regression with ≥ 10% residual tumor and ypN-site 2–3 were negatively associated with OS [
≥
10% residual tumor: hazard ratio (HR) 2.60; 95% CI 1.22–5.54;
P
= 0.014; ypN2–3: HR 3.59; 95% CI 1.60–8.06;
P
= 0.002). On multivariable analysis, only ypN-site 2–3 was predictive of OS (HR 3.67; 95% CI 1.55–8.69;
P
= 0.003), whereas histopathological tumor regression with ≥ 10% residual tumor was not (HR 2.24; 95% CI 0.98–5.10;
P
= 0.055).
Conclusions
ypN-site may have greater impact on OS than histopathological tumor regression in patients who received NAC plus surgery for non-type 4 LAGC.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-020-01098-w</identifier><identifier>PMID: 32572792</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Abdominal Surgery ; Cancer Research ; Chemotherapy ; Clinical trials ; Gastric cancer ; Gastroenterology ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Patients ; Surgery ; Surgical Oncology ; Survival</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2021, Vol.24 (1), p.197-204</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2020</rights><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-c64c3f70bb321b0121fa4230d5adc8aa83ee80a398384738996f37350439944f3</citedby><cites>FETCH-LOGICAL-c470t-c64c3f70bb321b0121fa4230d5adc8aa83ee80a398384738996f37350439944f3</cites><orcidid>0000-0003-4954-5047</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-020-01098-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-020-01098-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32572792$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fujitani, Kazumasa</creatorcontrib><creatorcontrib>Nakamura, Kenichi</creatorcontrib><creatorcontrib>Mizusawa, Jyunki</creatorcontrib><creatorcontrib>Kuwata, Takeshi</creatorcontrib><creatorcontrib>Shimoda, Tadakazu</creatorcontrib><creatorcontrib>Katayama, Hiroshi</creatorcontrib><creatorcontrib>Kushima, Ryoji</creatorcontrib><creatorcontrib>Taniguchi, Hirokazu</creatorcontrib><creatorcontrib>Yoshikawa, Takaki</creatorcontrib><creatorcontrib>Boku, Narikazu</creatorcontrib><creatorcontrib>Terashima, Masanori</creatorcontrib><creatorcontrib>Fukuda, Haruhiko</creatorcontrib><creatorcontrib>Sano, Takeshi</creatorcontrib><creatorcontrib>Sasako, Mitsuru</creatorcontrib><creatorcontrib>Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan</creatorcontrib><creatorcontrib>the Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan</creatorcontrib><title>Posttherapy topographical nodal status, ypN-site, predicts survival of patients who received neoadjuvant chemotherapy followed by curative surgical resection for non-type 4 locally advanced gastric cancer: supplementary analysis of JCOG1004-A</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background
Perioperative treatment is an accepted standard approach for treating locally advanced gastric cancer (LAGC). Histopathological tumor regression with < 10% residual tumor is a globally accepted prognosticator in LAGC patients who received neoadjuvant chemotherapy (NAC) and curative surgery. However, despite a response of the primary tumor, a significant percentage of patients dies from recurrence and identification of those at risk for relapse remains challenging. We re-estimated the value of histopathological tumor regression as a prognosticator alongside other factors, especially posttherapy topographical nodal status, ypN-site.
Patients and methods
Individual patient data including clinicopathological variables were used from the four JCOG trials investigating NAC (JCOG0001, JCOG0002, JCOG0210, JCOG0405) for analyzing prognosticators in patients with curative surgery excluding those with type 4 AGC by univariable and multivariable Cox regression analyses.
Results
Among 85 patients, 5-year overall survival (OS) was 46.0% [95% confidence interval (CI) 35.0–56.4] with a median follow-up of 3.2 years. On univariable analysis, histopathological tumor regression with ≥ 10% residual tumor and ypN-site 2–3 were negatively associated with OS [
≥
10% residual tumor: hazard ratio (HR) 2.60; 95% CI 1.22–5.54;
P
= 0.014; ypN2–3: HR 3.59; 95% CI 1.60–8.06;
P
= 0.002). On multivariable analysis, only ypN-site 2–3 was predictive of OS (HR 3.67; 95% CI 1.55–8.69;
P
= 0.003), whereas histopathological tumor regression with ≥ 10% residual tumor was not (HR 2.24; 95% CI 0.98–5.10;
P
= 0.055).
Conclusions
ypN-site may have greater impact on OS than histopathological tumor regression in patients who received NAC plus surgery for non-type 4 LAGC.</description><subject>Abdominal Surgery</subject><subject>Cancer Research</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kktv1DAQxyMEog_4AhyQJS49NOBXXtyqFS2ginKAc-Q4k12vnDjYTlb52nwCJmwXJA4cbI_t3_xnPJ4kecXoW0Zp8S4wyjhN6ToYrcr08CQ5Z1LkqRA0e3qyecXOkosQ9pSyrGL58-RM8KzgRcXPk59fXYhxB16NC4ludFu0dkYrSwbX4hyiilO4Jsv4JQ0mwjUZPbRGx0DC5GczI-M6MqpoYMDDw84RDxrMDC0ZwKl2P81qiETvoHenSJ2z1h2QaBaiJ4_OM6x629-RPQTQ0bgBOY95DGlcRiCSWIfXdiGqRUmN7lsVojea6HXr36PEOFroMRPlERuUXYIJa4KfNw93WDWZ3rxInnXKBnj5uF4m328_fNt8TO8f7j5tbu5TLQsaU51LLbqCNo3grMFKs05JLmibqVaXSpUCoKRKVKUoZSHKqso7UYiMSlFVUnbiMrk66o7e_ZggxLo3QYO1CssyhZpLlvNCyLJC9M0_6N5NHrNfqSJn-FvZSvEjpb0LwUNXj970-NCa0XrtiPrYETVdx9oR9QGdXj9KT00P7R-XUwsgII5AwKthC_5v7P_I_gKjHMbd</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Fujitani, Kazumasa</creator><creator>Nakamura, Kenichi</creator><creator>Mizusawa, Jyunki</creator><creator>Kuwata, Takeshi</creator><creator>Shimoda, Tadakazu</creator><creator>Katayama, Hiroshi</creator><creator>Kushima, Ryoji</creator><creator>Taniguchi, Hirokazu</creator><creator>Yoshikawa, Takaki</creator><creator>Boku, Narikazu</creator><creator>Terashima, Masanori</creator><creator>Fukuda, Haruhiko</creator><creator>Sano, Takeshi</creator><creator>Sasako, Mitsuru</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4954-5047</orcidid></search><sort><creationdate>2021</creationdate><title>Posttherapy topographical nodal status, ypN-site, predicts survival of patients who received neoadjuvant chemotherapy followed by curative surgical resection for non-type 4 locally advanced gastric cancer: supplementary analysis of JCOG1004-A</title><author>Fujitani, Kazumasa ; Nakamura, Kenichi ; Mizusawa, Jyunki ; Kuwata, Takeshi ; Shimoda, Tadakazu ; Katayama, Hiroshi ; Kushima, Ryoji ; Taniguchi, Hirokazu ; Yoshikawa, Takaki ; Boku, Narikazu ; Terashima, Masanori ; Fukuda, Haruhiko ; Sano, Takeshi ; Sasako, Mitsuru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-c64c3f70bb321b0121fa4230d5adc8aa83ee80a398384738996f37350439944f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdominal Surgery</topic><topic>Cancer Research</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fujitani, Kazumasa</creatorcontrib><creatorcontrib>Nakamura, Kenichi</creatorcontrib><creatorcontrib>Mizusawa, Jyunki</creatorcontrib><creatorcontrib>Kuwata, Takeshi</creatorcontrib><creatorcontrib>Shimoda, Tadakazu</creatorcontrib><creatorcontrib>Katayama, Hiroshi</creatorcontrib><creatorcontrib>Kushima, Ryoji</creatorcontrib><creatorcontrib>Taniguchi, Hirokazu</creatorcontrib><creatorcontrib>Yoshikawa, Takaki</creatorcontrib><creatorcontrib>Boku, Narikazu</creatorcontrib><creatorcontrib>Terashima, Masanori</creatorcontrib><creatorcontrib>Fukuda, Haruhiko</creatorcontrib><creatorcontrib>Sano, Takeshi</creatorcontrib><creatorcontrib>Sasako, Mitsuru</creatorcontrib><creatorcontrib>Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan</creatorcontrib><creatorcontrib>the Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fujitani, Kazumasa</au><au>Nakamura, Kenichi</au><au>Mizusawa, Jyunki</au><au>Kuwata, Takeshi</au><au>Shimoda, Tadakazu</au><au>Katayama, Hiroshi</au><au>Kushima, Ryoji</au><au>Taniguchi, Hirokazu</au><au>Yoshikawa, Takaki</au><au>Boku, Narikazu</au><au>Terashima, Masanori</au><au>Fukuda, Haruhiko</au><au>Sano, Takeshi</au><au>Sasako, Mitsuru</au><aucorp>Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan</aucorp><aucorp>the Stomach Cancer Study Group of Japan Clinical Oncology Group (JCOG), Japan</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Posttherapy topographical nodal status, ypN-site, predicts survival of patients who received neoadjuvant chemotherapy followed by curative surgical resection for non-type 4 locally advanced gastric cancer: supplementary analysis of JCOG1004-A</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2021</date><risdate>2021</risdate><volume>24</volume><issue>1</issue><spage>197</spage><epage>204</epage><pages>197-204</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background
Perioperative treatment is an accepted standard approach for treating locally advanced gastric cancer (LAGC). Histopathological tumor regression with < 10% residual tumor is a globally accepted prognosticator in LAGC patients who received neoadjuvant chemotherapy (NAC) and curative surgery. However, despite a response of the primary tumor, a significant percentage of patients dies from recurrence and identification of those at risk for relapse remains challenging. We re-estimated the value of histopathological tumor regression as a prognosticator alongside other factors, especially posttherapy topographical nodal status, ypN-site.
Patients and methods
Individual patient data including clinicopathological variables were used from the four JCOG trials investigating NAC (JCOG0001, JCOG0002, JCOG0210, JCOG0405) for analyzing prognosticators in patients with curative surgery excluding those with type 4 AGC by univariable and multivariable Cox regression analyses.
Results
Among 85 patients, 5-year overall survival (OS) was 46.0% [95% confidence interval (CI) 35.0–56.4] with a median follow-up of 3.2 years. On univariable analysis, histopathological tumor regression with ≥ 10% residual tumor and ypN-site 2–3 were negatively associated with OS [
≥
10% residual tumor: hazard ratio (HR) 2.60; 95% CI 1.22–5.54;
P
= 0.014; ypN2–3: HR 3.59; 95% CI 1.60–8.06;
P
= 0.002). On multivariable analysis, only ypN-site 2–3 was predictive of OS (HR 3.67; 95% CI 1.55–8.69;
P
= 0.003), whereas histopathological tumor regression with ≥ 10% residual tumor was not (HR 2.24; 95% CI 0.98–5.10;
P
= 0.055).
Conclusions
ypN-site may have greater impact on OS than histopathological tumor regression in patients who received NAC plus surgery for non-type 4 LAGC.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>32572792</pmid><doi>10.1007/s10120-020-01098-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4954-5047</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abdominal Surgery Cancer Research Chemotherapy Clinical trials Gastric cancer Gastroenterology Medicine Medicine & Public Health Oncology Original Article Patients Surgery Surgical Oncology Survival |
| title | Posttherapy topographical nodal status, ypN-site, predicts survival of patients who received neoadjuvant chemotherapy followed by curative surgical resection for non-type 4 locally advanced gastric cancer: supplementary analysis of JCOG1004-A |
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