Utilization and survival outcomes of neoadjuvant chemotherapy for early‐stage gastric cancer

Background and Objectives Given increased utilization of neoadjuvant therapy (NAT) for gastric adenocarcinoma, practice patterns deviating from standard of care (upfront resection) remain unknown. We sought to identify factors associated with NAT use and survival outcomes among early‐stage gastric cancers. Methods The National Cancer Database identified patients with early‐stage (T1N0M0) gastric cancer (2010−2020). Multivariable logistic regression assessed characteristics associated with NAT utilization compared to upfront surgery. After 1:1 propensity score matching, Kaplan−Meier methods and Cox regression assessed overall survival (OS). Results Of 6452 patients with early‐stage gastric cancer, 626 (9.7%) received NAT. Patients who received NAT were more likely treated at community hospitals, had moderate to poorly differentiated disease, and tumors located in the cardia (all p