UICC Staging after Neoadjuvant/Perioperative Chemotherapy Reveals No Significant Survival Differences Compared to Primary Surgery for Locally Advanced Gastric Cancer.

Dimpel, Rebekka; Novotny, Alexander; Slotta-Huspenina, Julia; Langer, Rupert; Friess, Helmut; Reim, Daniel

doi:10.3390/cancers14246169

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Title:: UICC Staging after Neoadjuvant/Perioperative Chemotherapy Reveals No Significant Survival Differences Compared to Primary Surgery for Locally Advanced Gastric Cancer.
Document type:: Journal Article
Author(s):: Dimpel, Rebekka; Novotny, Alexander; Slotta-Huspenina, Julia; Langer, Rupert; Friess, Helmut; Reim, Daniel
Abstract:: Background: The applicability of UICC TNM staging for gastric cancer (GC) patients treated with neoadjuvant chemotherapy (nCTX) and surgery was not yet analyzed in comparison to patients undergoing primary surgery (PS). The purpose of this analysis was to analyze if the prognostic impact of TNM staging after nCTx is comparable with PS. Methods: Data for patients having been treated for GC with or without nCTx between 1990 and 2016 were analyzed. Uni-(URA) and multivariable regression analyses (MRA) were performed to identify predictors. Survival according to the UICC 8th edition stages was analyzed by the Kaplan−Meier method and cox regression analysis. Propensity score matching (PSM) was performed to balance for confounders. Results: 1149 patients with GC were eligible for primary analysis. URA demonstrated age (p < 0.0001), tumor localization (p < 0.0001), clinical UICC-stage, complications, UICC stage 0, IIB-IIIC, Lauren subtype, grading, and R-stage to be significantly associated with OS. MRA revealed that age, distal tumor localization, more than 25 dissected lymph nodes, UICC stage 0, IIB-IIIC, and Lauren subtype were significantly and independently related to OS. After PSM, survival analyses revealed only a significant difference for pN2/ypN2 (p = 0.03), while all other T and N stages were comparable. Conclusion: UICC dependent survival stages do not change significantly after nCTx treatment for GC. Therefore, UICC staging in its present version is applicable to patients undergoing nCTx.
Journal title abbreviation:: Cancers (Basel)
Year:: 2022
Journal volume:: 14
Journal issue:: 24
Fulltext / DOI:: doi:10.3390/cancers14246169
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/36551654
TUM Institution:: Institut für Allgemeine Pathologie und Pathologische Anatomie; Klinik und Poliklinik für Chirurgie
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