Long-term survival results of patients with locally advanced gastric cancer and pathological complete response after neoadjuvant chemotherapy and resection

Tongbo Wang, Nianchang Wang, Hong Zhou, Aiping Zhou, Jing Jin, Yingtai Chen, Dongbing Zhao

Abstract

Background: To date, the long-term outcomes of patients with locally advanced gastric cancer (LAGC) who achieved a pathological complete response (pCR) after neoadjuvant therapy are elusive. To evaluate the impact of pCR on the long-term survival of LAGC patients who underwent neoadjuvant therapy and evaluate the necessity of postoperative adjuvant chemotherapy.
Methods: We conducted a retrospective study of clinicopathological and survival data of patients who achieved a pCR after neoadjuvant therapy and resection at the China National Cancer Center between January 2007 and December 2018.
Results: Ultimately, 39 patients enrolled in the current study, with a median follow-up time was 30.4 (range 2.5–101.6) months. The 3- and 5-year overall survival (OS) rates were 88.9% and 88.9%, respectively. And the 3- and 5-year disease-free survival (DFS) rates were 88.9% and 88.9%, respectively. During the follow- up, recurrence was observed in 3 patients. Of all 39 patients, 51.3% (n=20) received postoperative adjuvant chemotherapy and 48.7% (n=19) did not. There was no significant difference in OS (P=0.48) and DFS (P=0.47) between patients who underwent postoperative adjuvant chemotherapy and patients who did not.
Conclusions: Patients with LAGC who achieved a pCR after neoadjuvant therapy and resection might have a favorable OS and DFS. Our study failed to demonstrate the benefit of adjuvant chemotherapy for those patients.